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MONITORING WELL INSTALLATION REPORT <br /> Date: wiz CONSTRUCTION <br /> Premise Address: 3b65 Navy: '< e)`>Ix6z�av�i Total Depth 57-m- <br /> Screen Length (from) 41 (to) 57 <br /> Well No.: i"0&-Sc- Filter Pack (from) 44- (to) S4 <br /> Bentonite (from) 4Z. (to) 4.4 <br /> Inspector: Te.� 'fias.�o (os Grout (from) I (to) -q2 <br /> Drilling rig type CME. 95r <br /> Permit No. Dot,Sz o I Auger O.D. tL I.D. 4 [ <br /> Completion - rove pr ctu-istie box (circle one) <br /> Drilling Company: L. P. <br /> Driller: Tl7YY Ja`d ,a,{ casing <br /> 36 height <br /> Consultant Tr,ljekI rce� 33" <br /> Geologist llikt Iwtl <br /> ABOVE-GROUND CNAtSTY$OX <br /> OObWL.E CN COMPLETION <br /> SPECIAL PERMIT INFO. Ground Svixw 7- <br /> Distance to sewer line j&o kt- out <br /> Domestic well on site - (yn- <br /> If yes, location and distance- 1 n• <br /> n. <br /> q <br /> SAMPLING dotted <br /> "cdon <br /> Holding Temperature = gnytg Pack <br /> Method <br /> Screening Method <br /> Tracking Sheet - (y/n ) ' <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - CY--Y n) <br /> Storage Location Prov-kL s a1n ,rQ S'A, Casing type 2" S0n-c( U SO FVC- <br /> Blank 4-4ft. Screen 10 ft. <br /> Slot size o :h'L. <br /> GROUTING Bags cement 1' 47 it, <br /> Buckets bentonite I S� i6 <br /> Depth to water 16,4-t- Bags sand/gravel 9 Ih <br /> Mix Ratios 16 5 4 Filter Pack type/size M oApy z IL <br /> Installation Method au vv -treAA^Ajt Surge Block: - (( y n ) / <br /> Quantity Installed 7 y S U r Discussed with geologist: - yon) <br /> Type of method Sy+8 s� F—k? <br /> EH 29 29 <br />