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V G w:-LL DISMAL_r k iCN R 0P'T <br /> Date: J!/2 !p•� � ►a,,,/_ /(,/ <br /> ,c, Q� Total Depth <br /> e-^ <br /> ?- se Address: Seeea Lengtt•. (&oat) <br /> F! l� rater?ack Corm) (to) / <br /> Wel No•: 3eztoaite (frora) <br /> Grout CLota) d (to) 3 <br /> Inspector: Drilling ng type--�` <br /> D 2 Auger <br /> ?eriit No. = 5�0! Comoiedoa- Stove pipe/& stie box (circle one) <br /> Drlling Cotapanr. cas j meg <br /> Drller: � , <br /> 771 <br /> Cacsc:Ita^.c ��� ^• i• <br /> D GiRS 3CX <br /> C-tologisr C;,mP=,iGy <br /> cc=X-A sL.efacs -� <br /> S?oral vc :v-O. grad <br /> ,ti4T I <br /> G SO' <br /> Dista:.ce to sewer i^.e � V r <br /> Domesdc we on site - C Y/®) IL <br /> if,yes, location and dicta.-ic: - 'L' j <br /> — � 3 <br /> r <br /> o <br /> sbttod ::: <br /> Sl Lt?L:uG <br /> Holdir:g TtZ2 erattar- I, : <br /> Mehod � ELSce�^.insT;access sheet - CC' a �► r•. <br /> _• <br /> SPOILS <br /> M, A-1 I,gLS/D EVELOPI�T <br /> Storage Method I I <br /> Coataminatioa Noted- C Y Casing type 7- <br /> Storage <br /> Storage LocationBlank fG Steen fL <br /> Slot size <br /> GRO :ANG Bags c=enr <br /> Buccem bentonite <br /> Bags sand/gavel <br /> Depth to water rZLe-•Pack type/size 7A 2 <br /> 1rIiC Rados Suroe Bloat: - C Y AD <br /> Ins:aladon Method <br /> Quandt':-u:alled :. Z L'e1-'.� -- Discssed with geolos:st: - (®a <br /> Type of=ed od <br />