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&ONITORING WELL INSTALLATION REP& <br /> Azor -4 <br /> Date: g ��•Cl� �✓ �� C.ZSIr ,, CONSTRUCTION <br /> CAtof 1�Kton �aSerwe.cf <br /> Premise Address: 51D--KFDn o uc. ID Total Depth <br /> Screen Length (from) (to) <br /> Well No.: LIJ.� g Filter Pack (from) (to) <br /> NNn ^ .� � Bentonite (from) (to) <br /> Inspector: 'V �C/ Grout (from) (to) <br /> Drilling rig type YAocl ro t I queer }rj.CDl'Q <br /> Permit No. Auger O.D. I b" I.D. F <br /> Drilling Company: W �— <br /> `' 1 �.Q�'�S bycCompletion - Stove pipe/christie box (circle one) <br /> `pp«I ✓1� <br /> Driller: -kob Sc.hvoe�-- pDh Qb,2Af--(— <br /> casing <br /> height <br /> Consultant LUt�A -PLGIC,c Qecoll <br /> Geologists`� LD T <br /> Cc �e-�L ACONFL TICND <br /> COMPLETION CNAISTY-80X <br /> SPECIAL PERMIT INFO. Ground COMPLETION Sexy <br /> Distance to sewer line proof <br /> Domestic well on site - (y� is rr <br /> ft. <br /> PraleO -fb PJ2 _ Poshwt Cho--fD✓` toy,- ft. <br /> eCL:51 V-D to moi' a" ft. <br /> — s <br /> m <br /> o <br /> — c <br /> SAMPLING = 3 <br /> slotted c <br /> Holding Temperature 82 on '. <br /> Method gravel Pack <br /> Screening Method <br /> Tracking Sheet • (y/ n ) _ <br /> ft. = ft. <br /> :POILS <br /> )rage Method S t n MATERIALS/DEVELOPMENT <br /> itamination Noted - ( y/ n ) <br /> age Location 1 Casing type <br /> Blank ft. Screen h. <br /> Slot size <br /> TING Bags cement <br /> Buckets bentonite <br /> water Bags sand/gravel <br /> is Filter Pack type/size <br /> n Method Surge Block: - (y/ n ) <br /> istalled Discussed with geologist: - (y/ n ) <br /> hm• Type of method <br /> • 'gyp <br /> �OZ7 5111• �1�. <br /> `O h6L 4t,k hOL)f l V 6.03•0 w <br /> A- �u �m V(,IGk ko 301 <br />