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MONITORING WELL, INSTALLATION REPORT <br /> Date: CONSTRUCTION <br /> Premise Address: A O 5 SA Total Depth_ <br /> Well No.:_ K-, Screen Length (from) 112q- 5- (to) <br /> o ,g- <br /> Filter Pack (from) 00 (to)— <br /> Inspector: tl ,, Bentonite (from)_ qY (to) 10c>Anr a `_ Grout <br /> (from) F--(to)_ �!y <br /> Permit No. S rt S I Drilling rig type <br /> Auger O.D. I.D. <br /> P/ <br /> Drilling Company: Lorn.�\ ';o Completion - Stove pipe/christie box (cir <br /> Driller:- "M /I ( Z) <br /> casing <br /> Consultant_"('(Z height <br /> Geologist �n SP � ' Nnot � /180-0 —QV-T <br /> VEGFOUND <br /> COMPLETION CHR*TY-BOX <br /> - SPECIAL PERMIT INFO. ZCMPLEnON <br /> - <br /> �� Ground Surface 7 <br /> Distance to sewer line— <br /> Domestic Domestic well on site - (y/ <br /> If yes, location and dis e - <br /> O •5'g, _ h• <br /> , _ <br /> SAMPLING — c <br /> slotted — c <br /> Holding Temperature toclon — <br /> Method <br /> Screening od <br /> TracL set - (y/ n ) V. <br /> y — <br /> �,q <br /> 1=iift. = R <br /> SPOILS <br /> Storage Method �S�Mn� �n u MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( t crj 4 4- <br /> Storage Location—na Casing type L Lt O P vc <br /> Blank lO - ft. Screen------S- g. <br /> GROUTING Slot size . O'Lc) <br /> Bags cement <br /> Depth to water Buckets bentonite <br /> Bags sand/gravel 3 •S (,m <br /> Mix Ratios_1Q-Y t(, ( - _ ,, AS %-I ( W� Filter Pack type/siz <br /> Installation Method 5 <br /> Quantity Installed_ '^^^ - Surge Block: - 0y,/n ) <br /> Discussed with geologist: - ( y H) <br /> EH 29 29 Type of method <br />