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MONITORING WELL INSTALLATION REPO'R",, <br /> e - <br /> ow i <br /> Date: CONSTRUCTION <br /> Premise Address: �}G g 00 m i r Total Depth <br /> Screen Length (from) 55'' ' (to) 30 1 <br /> Well No.: w- Jr^ Filter Pack (from) 53'- (to) R8 <br /> Bentonite (from) y2B (to) 2.0 <br /> Inspector: v Grout (from) 21, (to) rt"-A <br /> Drilling rig type �'r/J?(,C '7s-� <br /> Permit No. 0 Q S jQ Auger O.D. /o `' I.D. <br /> T Completion - Stove pipe/christie bo circle one <br /> Drilling Company:_ }�,�SO 1'1 L},rtf �tyl i`c.d��,����a`� <br /> Driller:_ A 0 Y!Y/g2z? aaiern� casing <br /> _ height <br /> Consultant rJ <br /> Geologist �t C darn /JA? o G h •_ <br /> ABOVE-GROUND <br /> COMPLETIONCI fCOMPLETION TION <br /> SPECIAL PERMIT INFO. T D Ground Surface <br /> y <br /> Distance to sewer line Urf&a 0Z';'-t /05-,5, <br /> �0 rs� grout <br /> Domestic well on site - (y/� PP <br /> S,S' �,,,Z <br /> If yes, location and distance - 0•�/ ft.28 ft. <br /> 30,S' '- <br /> 3J <br /> SAMPLING '¢I' - •7/. O _ o <br /> slotted <br /> soc�on <br /> Holding Temperature__ <br /> gn�w Pack <br /> Method i G !f!&, <br /> /rim <br /> Screening Method D <br /> Tracking Sheet - n ) — <br /> SPOILS <br /> Storage Method SS-_� U ri�J MATERIALS/DEVELOPMENT <br /> (Q' <br /> Contamination Noted - n /� <br /> Storage Location 0-'-2 S; Casing type <br /> Blank 3Q ft. Screen 2S- ft. <br /> Slot size 0, 02 ,0 " <br /> GROUTING Bags cement f IL <br /> Buckets bentonite 2 Sb 6'q lo( <br /> Depth to water ;�02 Bags sand/gravel4,4 • L 11Y� <br /> Mix Ratios 47-lb v le +L—..l—..l <br /> _ Filter Pack type/size 44- 3 <br /> Installation Method � <br /> - Surge <br /> � <br /> Block: - (y <br /> Quantity Installed 3 bad lh p�`� Discussed with geologist: - ( y/ <br /> 1•Zr b�s ��-a.s sill ��U Type of method <br /> EH 29 29 7 161 ��-�r/(•n /�z 0 <br /> 3rd 3 b r'''/0 lv4,,�e <br />