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MONITORING WELL INSTALLATION REPORT <br /> Date: CONSTRUCTION <br /> Premise Address: •3015 KjAu. IDrw T54} o-*,.Cq Total Depth <br /> Screen Length (from) to (to) -As <br /> Well No.: lt>/RL 313 Filter Pack (from) a3• (to) 35 <br /> �}- Bentonite (from) '269 (to) 2 3 <br /> Inspector: j7a I Z5 LrILDIt-3 Grout (from) O (to) <br /> Drilling rig type C nnE's 95 <br /> Permit No. ©0 (&5201 Auger O.D. g I.D. <br /> Completion- bsove i e christie box (circle one) <br /> Drilling Company: �.a,SCz��rA�Gwo y L-' F'` <br /> Driller: T'W S A`aYy j casing <br /> - height - <br /> Consultant�qS 33 <br /> _ <br /> Geologist fkc Doli •- <br /> ASOV@-GfiOUND <br /> Of-[MM-BOX <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. G=nd Suixa <br /> Distance to sewer line ?yo (4- grout <br /> Domestic well on site - (y 49 2-g . n <br /> If yes, location and distance - <br /> 3Z, <br /> o <br /> 0 <br /> SAMPLING ) �lattad <br /> wcdon s. _ <br /> Holding Temperature = Waw Pa:k <br /> Method ` _= <br /> Screening Method <br /> Tracking Sheet - (y/ n) <br /> 35 ft. <br /> SPOILS <br /> Storage Method O +'all o b•v. MATERIALS/DEVELOPMENT <br /> Contamination Noted - n <br /> Storage Location Vwvq- bs S!*-- Casing type Z° sJn--JU-t 4AD mac•' <br /> Blank _. ft. Screen S ft. <br /> Slot size —Z"XL <br /> GROLMNG Bags cement <br /> Buckets bentonite_ I So 6 <br /> Depth to water Bags sand/gravl6 <br /> Filter Pack type/size Y *Yik-urs <br /> Mix Ratios a)J'16�/ 5 52��5 Z lZ <br /> Installation Method an y „nir Surge Block: - a/ n) <br /> Quantity Installed tTv Aak)4�5 Discussed with geologist: - ((3?/ n) <br /> Type of method Srnul h� cwsa <br /> EH 29 29 <br />