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*MONITORING WELL INSTALLATION REPORT <br /> Date: 2 1'1.9S 1459' CONSTRUCTION <br /> Premise Address: 2,401 AACA2.TthlR_ Total Depth 2-1 <br /> Screen Length (from) Z'i' (to) 1 ' <br /> Well No.: Mu) 15 Filter Pack (from) Z"I (to) 5' <br /> Bentonite (from) 5' (to) A <br /> Inspector: l 0w6 Grout (from) 3' (to) 0' <br /> Drilling rig type GM e. -15 <br /> Permit No. Auger O.D. t D" I.D. <br /> Completion - Stove pipe/ sne o (circle one) <br /> Drilling Company: SaEU"M <br /> Driller: Vxtj LEommaj casing <br /> height <br /> Consultant <br /> Geologist t70uC� <br /> ABOVE-GROUND CNRISlY 80X <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surixs <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) 313' ft <br /> if yes, location and distance - , tt <br /> n. <br /> = m <br /> — o <br /> _ o <br /> SAMPLING slotted _ S <br /> q aC sac.on —_ <br /> Holding Temperature _ grays,Dack <br /> Method twe; ICENn-- tce la'1� <br /> Screening Method Mb : 4,S!, .4� ji',7A.�([�' o"6t/Z3",lb (e� ) <br /> Tracking Sheet n ) P.nS <br /> SPOILS <br /> Storage Method fL J (1(i UNDEIL(5rt�d, MATERIALS/DEVELOPMENT <br /> Contamination Noted - / n ) <br /> Storage Location D R Sr6 Casing type 4" PVC. (5cA 4D) <br /> Blank 1' ft. Screen ZD' ft. <br /> Slot size 0 OZ.O" <br /> GROUTING Bags cement 1 <br /> Buckets bentonite 1 (SWA) Vag Palled <br /> Depth to water 16 Bags sand/gravel <br /> Mix Ratios :7. t1 1.0 ?Ilkfn Filter Pack type/size -4/1-L <br /> Installation Method Surge Block: - ( y/ n ) <br /> Quantity Installed Discussed with geologist:AG � 2�a ciG- (& n ) <br /> Type of method V <br /> EH 29 29 <br />