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MONITOR WELL CONSTRUCTION <br /> Logged By: ✓ & Client: <br /> Drilling Contractor: Location: �' ' <br /> Driller's Name: Job Number•. - <br /> '� <br /> Well Number: Date/Time: Star> 'CPinish /42 <br /> Comments (Lost caculatlon interval, alar level changes. Hole collapse interval, eie . <br /> Depths in Reference <br /> to Ground Level <br /> Top of <br /> Loekinq Cap <br /> Protective Casing— <br /> Protective Pipe O q G <br /> Type, Diameter <br /> Top of Well Casing <br /> CamentlGravel Pad <br /> Top of Cement--- <br /> <a <br /> Bottom of <br /> Protective Casing <br /> ,1 <br /> Ground Water -----y — <br /> Type of Grout 1UPzza&12±f✓�� <br /> Casing: <br /> e - Type---��.-�_q/�Y !/ <br /> Diameter. C/ <br /> Couplings: <br /> Type d <br /> Number <br /> li. Deplhs 613a,5 Y 1141, <br /> Top of <br /> Bentonite Seal - Type of Plug <br /> i Top of Gravel Pack- <br /> �O Gravel Pack: <br /> Top of Screen ----- -� Material J !i <br /> Screen, U ®✓/t1 <br /> - --_- TYPe r t <br /> - _ Diameter <br /> Longth <br /> ---_ - Slot Six• � L!� ^�—� <br /> Bottom of Screen Bore Hole Dlameler <br /> Total Depth <br /> of Bore Hole <br /> NOT TO SCALE <br />