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`MONITORING WELL INSTALLATION REPOR F <br /> SUnR�, 4ou+ '7b ' F <br /> Date: OV c onbe f at .?t7 /r CONSTRUCTION <br /> Premise Address: Z,92:1 Pyla A M, Total Depth__ <br /> Screen Length (from) 3D (to) /o <br /> Well No.: Filter Pack (from) A p — <br /> / Bentonite (from) (to) S <br /> Inspector: M 8AArb2,&„ Grout (from) S (to) Sof16 c e <br /> Drilling rig typeunit G <br /> Permit No. 06 (a3712— Auger O.D. ayy *' 1.D. Y741 y DP <br /> Completion - Stove pipe/ shebbx7 (circle one) <br /> Drilling Company:_ s-T <br /> Driller: casing <br /> Ass i st earlos Mor o Ern-erh C-rfrz//sl +- height <br /> Consultant fiYarl 114 6Ca�i7✓iron A��� /!?draos <br /> C,F� nt041 r��Q ye'Z. T <br /> Geologist L U i S (z4 rG�e - G E ✓ .W_ T <br /> ABOVE-GROUND <br /> 0C&9LETION X <br /> SPECIAL PERMIT INFO. Ground Surface COMPLETION <br /> .� <br /> Distance to sewer line_ }SO -Feet Grout <br /> Domestic well on site - ( y/©) ,�S ft <br /> If yes, location and distance <br /> ft. ft. <br /> � m <br /> b <br /> C <br /> SAMPLING <br /> totted <br /> Bacton <' _ <br /> Holding Temperature40 <br /> Method <br /> Screening Method P I C ;.,IJ oa L Gt G -,,M Al P <br /> Tracking Sheet n ) :. <br /> 3 o n. = 3 L n. <br /> SPOILS <br /> Storage Method Jj;n MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y/& <br /> Storage Location_ &n Casing type 2 /y fid � + yae�u�� 5�,7 <br /> Blank 16 ft. Screen oZ 0 ft. <br /> Slot size e)0Lv N <br /> GROUTING Bags cement 7 S <br /> Buckets bentonite / Pvra So <br /> Depth to water ^17-4540- Bags sand/gravel�� bo �D 6 ) z:6"� <br /> Mix Ratios .v J1, Filter Pack type/size <br /> Installation Method /��,o�� Surge Block: - ( y/ n <br /> Quantity Installed 3 h� �,(,�f Discussed with geologist: / n ) <br /> Type of method <br /> EH 29 29 <br />