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MONITORING WELL INSTALLATION REPO <br /> Ope .dam k tok2,kcwt- <br /> -lhthcl �oca-ho„ .p�. 2 <br /> both ot4yA a w+ fit's ww, 4LQ c` 1].Cac0 TL <br /> .Q (yp nGrG•�C wuq P�nco✓Mt-�zdf�-'�V ht <br /> Date: io ea J CONSTRUCTION `� '� QS�OG• W� v L�4 of <br /> 'ek <br /> Premise Address: 1 s• C" ""^� Total Depth g <br /> r. <br /> Screen Length (from) $ (to) <br /> Well No.: MW Z) Filter Pack (from) S (to) 53 <br /> Bentonite (from) S3 (to) 51 <br /> Inspector: M 2ct y s Grout (from)—(to)— <br /> Drilling <br /> from) (to)Drilling rig type GME *5 14T <br /> Permit No. Auger O.D. b /4 I.D. <br /> Mie �1 ���1`J Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: l <br /> Driller: SG0 -Vi— casing <br /> De height <br /> Consultant 11 AA <br /> jffT <br /> M —Erw-f <br /> Geologist N`,� y LVI� 7 •- <br /> Wel� W-vm {aQ d !eL4Lopt Bn COMPLETIONO CHRISTY-BOX <br /> COMPLETION <br /> S ECIAL PERMIT INFO. Ground Surtax <br /> Di ceto erline N Grout Lbn <br /> Do tic 11 sit tt ' <br /> If y s, oc tion d istan e 5553 <br /> tt tt. <br /> ✓mp 3 ✓cdv�e WjSE ; _ <br /> sa3w P,+Yk of tLe lord t-v1 ryh^Qe4-`&s - <br /> �t�f kd a >ai 1-e Wovul �k spur _ <br /> Torn cvoja - WS s-c.Svd.c cert abau- if SAMPLING �IOdOb5LrMC( slottedI` cto a�,C section — <br /> Hol ' g Temperature — 1 <br /> Meth d J ! - Pack <br /> Scree ing e t <br /> Trac ' heet - (y/n ) <br /> IrLl k e -5k,.4tA T' ab fL <br /> "Q"4•�. %tZ I l "a lrraded <br /> SPOILS #r*A.+ of A va y„G-e pai a.,vt {rWedb lM c <br /> 5$, t%V H�of ti. 4" " d9 4ti, Achawk Pyvp'^ks <br /> Storage Method On pla3 jy, MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ iQ <br /> Storage Location � � h,- ' tLot tt Casing type 2 !! G <br /> Blank ' 5 ft. Screen 3-b h. <br /> Slot size C)2co <br /> GROUTING Bags cement <br /> L1 Buckets bentonite <br /> Depth to water 4 r - _ Bags sand/gravel <br /> Mix Ratios S: 4 1 b bq&o 55 WZ Filter Pack type/size 6P-1 AF19 <br /> Installation Method kvt-' Le- P i pG 35 Surge Block: - (y/n ) <br /> Quantity Installed -tr4ka ipari0 Discussed with geologist: - (y/n ) <br /> Type of method <br /> EH 2929 7pG�te� �1�Fj� �Dr INVN@ �� SG`{1 $ CdbC�4 1eweJ � <br /> Sgc�{jdot d 1v�s N <br /> �U r m F e! l2tl f `�l.e V o le, `J cod 11-x- Gini(/-,o +Lnc-i6bve,ti. <br /> 6Y1L11.NA w,L � Sn���.t ilrHf nil.,9at ,��,yN. <br />