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i <br /> v - MOI; FtNG wF..LL INSTALLkTION REPORT <br /> E <br /> F �3 <br /> Date:— ! l .» _CONSTRUCTION. <br /> a:e.^:ise Address: &±e <br /> Taal Depth 3 <br /> Screen Len h Cfrom) (to) <br /> 2,2- <br /> Well No.: 5 - :Fiilte-r Pack {from} (to) 2- ._ <br /> Ben[onite (from) 27— r(to) ' _ <br /> Insoec•or. - » -. Grout (from) 2, 1 (to) .. <br /> �3Drilling rig type 'S <br /> ?er:nit No. `/z ?Z ;, - --Auger O.D. I.D. � - <br /> fight <br /> Compl - Stove pipe/chrstie box (circle one) <br /> Drlling Company. /�Jf <br /> 3 i1-7 TY <br /> Consultant - <br /> •� . <br /> Geologist .. -. �= Jl.SCYc ,. 'ND .�.._. �¢TT <br /> te7�=;CN CCMP;.=T3CN F <br /> �» Cxourd Sumacs y <br /> SPECIAL PE.42 IT INFO. grout :f <br /> Distarce to sewer line y <br /> Domestic we>I on site - C y/ n) Z Z tL <br /> If yes, location and distance - A ft• <br /> 4. <br /> SAM_?LiNG <br /> Floidi.-:a Tem erasure <br /> Me:hod � � • � �� — �q <br /> Sc:eenin Method <br /> Tracking Sheet - / n <br /> h � F � � � y` . y s.••y5.• '•i�A. 1 S,� ry. 1�w , .- w, ..- v,, ,. i <br /> SPOILS <br /> Storage Method - <br /> ' 3I1de,'iTRIALS- EVELOPIIENT t. <br /> Contamination Nated • (y/ ri ; <br /> Stora;e Location r Casing type fr. <br /> Blank Z fr. Screen <br /> Slot size <br /> • Bags cement 4 <br /> CEOLMNG _. .t - Buckets bentonite g <br /> Depth to water �- J & Bags sand/gravel - 1 <br /> Mi.Y Ratios <br /> f Filter Pack type/s'ze 3 <br /> Installation Method Surge Block: - n} <br /> Quantity Installed - w" Discussed with geola 'st: - { ) <br /> - _ .. . Type of Method <br />