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--MONITORING WELL INSTALLATION REP(.--c <br /> Date:���/-( / CONSTRUCTION <br /> Premise Address: ll `v Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: Completion - Stove pipe/christie box (circle one) <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist ,_ <br /> AE&r:-GROUND <br /> COMPLETION CHR S TY-80X <br /> SPECIAL PERMIT INFO. Ground Suriact COMPLETION <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - ft. <br /> ft. ft. <br /> m <br /> SAMPLING = <br /> slonad <br /> sac�on _ <br /> Holding Temperature = <br /> Method _ gr"'9I Pack <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) _ <br /> Il. � <br /> ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft. Screen fr. <br /> Slot size <br /> GROUTING Bags cement <br /> �/ Buckets bentonite <br /> Depth to water 70� Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />