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MONITORING WELL INSTALLATION REPORT. <br /> Date: 51-tw 10.6 CONSTRUCTION <br /> Premise Address: ri y0mim, 5 Total Depth SO <br /> Screen Length (from) %5' (to) 50' <br /> Well No.: V�E-W-) -I _Zy�Z Filter Pack (from) ?,�' (to) so' 3 " <br /> Bentonite (from) 31, (to) 3t, <br /> Inspector: 0 iAAncc— Grout (from) (to) <br /> Drilling rig type <br /> Permit No. 5`13 S 0 Auger O.D. I.D. <br /> Completion- Stove pipe/christie box (circle one) <br /> Drilling Company: 'A10= ( <br /> Driller: casing <br /> height <br /> Consultant_ -WW-F <br /> Geologist ABOVE-GROUND <br /> CHEZ rY-90X <br /> COMPLETION <br /> COMPLETION <br /> SPECIAL PERMIT INFO. end suAa" . <br /> proal <br /> Distance to sewer line <br /> Domestic well on si y/ n ) 1 ft. <br /> If yes, locatio d distance - ft. <br /> tt. _ <br /> a <br /> SAMPLING <br /> sac9on <br /> u'' = <br /> Holding Temperature mA (4A = 9n <br /> Method (" �n I OA J%4 4 .•.. <br /> Screening Method Pin <br /> Tracking Sheet / n ) s, <br /> SPOILS <br /> Storage Method S� MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> n i� s f- fic Casing type L PVC <br /> Storage Location <br /> Blank_ 2 5 ft. Screen <br /> Slot size - <br /> GROUTING Bags cement 6 <br /> Buckets bentonite l <br /> Depth to water Bags sand/gravel <br /> Mix Ratios rt1) <br /> Xt l� �I�L- Filter Pack type/size z Z Stow <br /> Installation Method �� Surge Block: - ( y/ <br /> Quantity Installed Discussed with geojo—gist: - ( y,Qr ) <br /> Type of method <br /> EH 29 29 <br /> i � � <br />