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MONITORING WELL INSTALLATION REPORT <br /> Date : ei L) s fi 2 D (24 - CONSTRUCTION <br /> Premise Address : 8 I7 Sn U Fk dto Total Depth <br /> Screen Length Urom) 2 ! f& Ck (to) <br /> Well No.: Y tef Z W L 1A/ 71 _ g Filter Pack (from) (to) <br /> Bentonite (froGrout m) to) <br /> Inspector. VIC �CI � � ^ ear-h) i J Driltn r efrom) 9361 (to) <br /> a s tyP � <br /> Permit No. Auger O.D . / D i ndh I.D. ! l n <br /> completion - Stove pip chrisde bos ' cle one) <br /> ! s thctj <br /> Drilling Company, re. 3 <br /> ➢Tiller: �o r ¢9�y casing <br /> r ver - Crre�9 Q s 'sfant� he :ShG <br /> consultant J ) m a e �/ C / 2Arwalfer Group <br /> Geologist . � i vn �LY � e U APAVEGRCUND \ <br /> COW LETfGN C�R:STY30X <br /> SPECIAL PERMIT INFO. <br /> ^y � �j TP� e prtat <br /> Distance to :ewer line <br /> Domestic well on site - ( y / n ) <br /> if yes, location and distance - h• <br /> 10 tt . <br /> florod <br /> SAMPLING soccn 2 <br /> Holding Temperature N k <br /> Method ivy <br /> Screening Method nl A <br /> Tracking Sheet - ( y / ri N tit <br /> SPOILS <br /> Storage Method 5S - 4Q d ow drv .ras Oji—Sr fC MATEW AIS/DEVELOPMENT <br /> Contamination Noted'. ( y / n ) <br /> Storage Location on 1114+c CasinS a t n Seld <br /> ufe 49 ft <br /> Blank1 U fc. Screen 15 _ <br /> Slot size 1 • O Z inch Yo ' <br /> GROtiRNG Bags cement 12 94 bout T <br /> LL Buckets bentonite t 56 <br /> e a o ,p <br /> Depth to water / T �� Bags sand/gravel 16 / DDOouK 1 lal-a1) <br /> Mix Rados ont 9e , . G g41/ayt � Fiber Pack type/size <br /> dtts[alladon Method r r Surge Block: - (© u ) <br /> + Ile t- <br /> Quantity Installed / • a /l n r Discussed v4th n ) <br /> Typeofnethod SuirT9A / D ink <br /> EH 29 29 <br />