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ONITORING WELL INSTALLATION REPOA <br /> Date: NOyemb�r -20U r7 CONSTRUCTION <br /> Premise Address: -PR&;fiAve-. Total Depth PO -et <br /> OnA aZroamin H0 I+ -Dr. ' Fr��r' '� RtrP, Screen Length (from) 80 (to) (. S <br /> Well No.: i✓RD - 12 `7 3 - A L Filter Pack (from)_ bo (to) 64- <br /> Bentonite (from) (.4 (to) 2 <br /> Inspector. i r-k.* /1 /�QC+n e-u __ Grout (from) C 2 (to) SVr i <br /> Drilling rig type E <br /> Permit No. ('9.57Z/9 3Auger O.D. i?- i nem I.D. . ZS <br /> 1. I Completion - Stove pipe/ u-tsde b circle one) <br /> Drilling Company: SOLI.Trum E�YgTiOf+. <br /> Driller: -F6 n casing <br /> AzsS r fA, -r - b; 111 I S i JAmc.r 1I'lG�� I'� , he±ght <br /> Consultant t- F R <br /> Geologist M i GytAe� Su J ',vq,n F R T <br /> ABOVE-GROUND CNAISTY80X <br /> COWL-7ION <br /> SPECIAL PERMIT INFO. Ground SuAac* <br /> Distance to sewer line '7-F Seel Oran <br /> Domestic well on site - ( y/ n ) T-ePtD 2• • ft. <br /> If yes, location and distance - r f<- <br /> > 100 -1 5 `) '7 �e�ft. _ <br /> l0 ' o,7 <br /> 15, o.3 =a <br /> a0' U. I — <br /> �S . 0.3 <br /> SAMPLING 50 0-3 <br /> 35' 0.3 Bohai <br /> sat7on '^ <br /> Holding Temperature N AC Q0,, O.L = gravel pads <br /> Method N A, 45 0.$ - <br /> Screening Method 1 50' a, 7 <br /> Tracking Sheet y n ) Y/ 0' 0.8 <br /> 45, <br /> 70' 0•L <br /> SPOILS 15 d-5 <br /> r� g� _ 0.3 <br /> Storage Method roll ots 6n MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y/0 <br /> Storage Location Casing type 5 h.e(ul� �0 <br /> Blank----C S ft. Screen 15 fr• <br /> Slot size 0 .02-0 11 <br /> GROUTING Bags cement s af4,7A6 <br /> Buckets bentonite <br /> Depth to water re Bags sand/gravcl <br /> Mix Ratios✓ ,� kgJ Filter Pack type/size <br /> Installation Method r mi I .t� ' Surge Block: - ( y/t0 <br /> Quantity Installed 3 ha, r&PS o -f rife..-I .6r Ar Discussed with geologist: - ( r'/ n ) <br /> Po r 14n d CLrizLrtf Type of method <br /> EH 29 29 <br />