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� 1 <br /> ONITORING WELL INSTALLATION REPOT f# <br /> Date: -22 �PQ4!7 . CONSTRUCTION <br /> Total So ' <br /> Premise Address: -Enf rcu iia - Q �' `��� ' ScreeDL�ngth (from) 8n ` (to), 6S ' <br /> 4k'1,0( 9rn%n 1-1n1 t fir. - rLa, <br /> E: D - 12411- -A L Filter Pack (from) 80 (to) r, <br /> Well No.:_ Bentonite (from)_ G (to) 62- <br /> Grout (from) 2 (to) .50r 4t'c <br /> Inspector. i/ 12� C r+n awn Drilling rig type C C- <br /> D5 zG 3 s Auger O.D. A I.D. �LE2S <br /> Permit No. I duisde box ircle one <br /> Drilling Company: SIO Irvn, x�T � Completion - Stove pi� <br /> casing <br /> Driller:_ 11 1height <br /> ✓�6siat fi :115 1 h"ish; J4tV,;r'ALEn7YL re, - VC4-SZ7Y-BOX <br /> Consultant L Evt`ne Er ' cky ' LER <br /> Geologist pBOVE•GRCUND <br /> cONIPLETION <br /> SPECIAL PERMIT INFO. '® Oround Su taco <br /> prcut <br /> Distance to sewer line 7 +6 S �ee� <br /> Domestic well on site - ( y/ n ) ft. <br /> If yes, location and distance - � ? 19,;Ad: ft• <br /> > 1 <br /> /0 ' 0.3 <br /> _ 'a <br /> — a <br /> aot �• S =_ <br /> zs t 0.7 dor." = <br /> SAMPLING 30 0. /, sec cn _ S <br /> HoldingTemperature3S' / 0 = vd <br /> /J SGd 1. I — F <br /> Method <br /> Screening Method 1 7 — <br /> Tracking sheet - y n) SOI <br /> SS" 0•8 -2u2—ft. = Ito <br /> 4 a I l.9 <br /> SPOILS G� <br /> Storage Method r'Q 1 o frF n 75 MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y Aa 8 e SP ha 14 40 <br /> Storage Location Casing type <br /> Blank_f�� ft. Screen <br /> Slot size 0.02O ' <br /> GROUTING Bags cement 23 b4RS <br /> Buckets bentonite_ 2 � <br /> Depth to water �� FP Bags sand/gravel <br /> - <br /> Mix Ratios�N�0��1�r,�rei if L.Js{� in R lxi�j Filter Pack type/size <br /> �---3— <br /> Instal lation Meth�1=r 60t G Surge Block: - ( y/ <br /> Quantity Installed 1�m*A bos r e T�VT-IrDiscussed with geologist: - i n ) <br /> �ortldrel� C�Az Type of method <br /> EH 29 29 <br />