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NIITORING,rLL INSTALLATION REPO - <br /> Date. p CONSTRUCTION <br /> Premise Address: r D f.� C_ Total Depth 5 <br /> Screen Length (from)„ I _ (to) <br /> Well No.:.. Filter Pack (from) Z Sr -—(to) 3 <br /> :y < Bentonite (from} (to) <br /> Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permir No. <br /> Auger O.D. <br /> Completion - Stove pipej6hristie box (c one) <br /> Drilling Company: / a <br /> Driller: casing <br /> height <br /> Consultant <br /> Geolggist A80VS-GAGUN0 <br /> 0_F*TY-80X <br /> COWL.ETION COMPLETION <br /> SPECIAL PERMIT INFO. 5urf'ce <br /> Distance to sewer line_f�>` <br /> Domestic well on site - (y/n) <br /> If yes, location and distance - ;I 3 ft. <br /> R. <br /> v — 7 <br /> SAMPLINGdr <br /> &*den � — <br /> Holding Temper lure o <br /> pack <br /> Method — <br /> n�x <br /> Screening Method <br /> Tracking Sheet - {y/ n ) <br /> a SPOILS <br /> Storage Method MATERIALS EVELOPMENT <br /> Contamination Noted - n f <br /> Storage Location X Q42 Casing type <br /> BIank _5 fL Screen ft. <br />+' „ Slot size U <br /> 1 GROLITING Bags cement <br /> Buckets bentonite <br /> Depth to water S Bags sand/gravel <br /> Mix Ratios— Crnr.e M .1 Filter Pack type/size -3 <br /> N Installation Method Surge Block: - (y�) <br /> I <br /> Quant iry Installed Discussed with geologist: <br /> Type-of method <br /> EH 29 29 <br /> rA� <br /> e <br />