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• New a <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: a -3l—Z 17 CONSTRUCTION <br /> Premise Address: 3015 ht ayY—C>'&& 5iockis., Total Depth 50 �A— <br /> Screen Length (from) 40 (to) SO <br /> Well No.: —tt' G Filter Pack (from) 2 .4 (to) 5'7c <br /> Bentonite (from) 35 (to) 3--f <br /> Inspector: Grout (from) © (to) 35 <br /> Drilling rig type CA.tig 95 <br /> Permit No. ©o(oS-Lo 1 Auger O.D. V I.D. - <br /> Completion - Stove pipe/ nsne o (circle one) <br /> Drilling Company: �SCa1J.a �L u.��u�\e_r 4•Q• . <br /> Driller:— oYY rJaA a jra r casing <br /> � (�, height <br /> Consultant �'yv�'vHe�nrnaTer�..vr,�oei�s Cww...n)-�'y�z„ „ <br /> Geologist Mike Noll �� <br /> ABOVE-GROUND Ctfri15TY-BOX <br /> COWLETION COMP=ON <br /> SPECIAL PERMIT INFO. Ground Sulx <br /> T ,-mom <br /> Distance to sewer line LC ID Grout <br /> Domestic well on site - (y 0) 35 n <br /> If yes, location and distance - <br /> �n. n. <br /> F ^ .. <br /> — o <br /> b <br /> SAMPLING Nc)YA— slotted = c <br /> saction <br /> Holding TemperatureVXV1W Pack <br /> = <br /> Method <br /> Screening Method <br /> Tracking Sheet - (y/ n ) <br /> SD n. I F <br /> 11 _ ft. <br /> SPOILS <br /> Storage Method Ov\iX1lL vol(-A bi' MATERIALS/DEVELOPMENT <br /> Contamination Noted - 43yr n ) <br /> Storage Location ymeyA1.., BcR Casing type 2" ncAAA-W�- 40 CNS <br /> Blank 4fl ft. Screen <br /> Slot size (J Otn t rl <br /> GROUTING Bags cement V", 43 1L <br /> Buckets bentonite S 1b <br /> Depth to water Bags sand/gravel 9 Sb <br /> Mix Ratios 94-11>s S �z(lurs Filter Pack type/size tiAowAov <br /> Installation Method a •kwsrn A+ Surge Block: - (YV n) <br /> Quantity Installed z , s Discussed with geologist: - 0/ n) <br /> Type of method Svwvt c swea <br /> EH 29 29 <br />