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MONITORING-WELL,INSTALIATIOREPORT <br /> rj <br /> { Date: Y 1 S. 2 00 SUr! GGj <br /> ✓✓ CONS'TRUCI"tON � <br /> Premise Address: � - <br /> -`�,� Total Depth i1 5" <br /> Well No. M �/`/ - O 5creeri Len h (from) 3S (to) <br /> Filter Pack (from)_ 3S ` (to) !.2 ` 7 <br /> Inspector. Bentonite (from), 0 <br /> (from) <br /> Grout j ) <br /> i <br /> Permit No. 3 Drilling rig type— <br /> Auger, _D, j� LD. <br /> ; <br /> Drilin . vJAComple1 ton -;,k Stove pipe/dtisde hoz Ccircle one) <br /> Driller: i� <br /> ^. �On�_jad, <br /> casing <br /> As-s i sf`4mf5 1...4) lirf � height <br /> Consultant E IL m erL�"Q IFNJ } <br /> GeologistW c2122- le <br /> i <br /> SPECIAI.PERMIT INFO. f I CoM t;;7nC,t4 <br /> Ground Su�aca <br /> I <br />` Distance to seiver tine- .67 .�j-f �,� I prcct <br /> Domestic well on site,- <br /> If yes, Iocation and distance <br /> D I S 17,2 -�G -� G�o m.es f i c iJe• 1 <br /> Y Il <br /> SAMPLIN <br /> Holding Temperature -e- ° <br /> tocicn "• � <br /> Method <br /> Screenin?Method <br /> o L� I 4Acre.W s )Io <br /> Q <br /> Tracl<ingShcet -CYY n ) I( edQrlvcks�q� — <br /> an h :s nos35- <br /> e <br /> 50;'I S4r&pjeS We4-e_ Co Penejelv( a]- " ` fit <br /> SPOILS oo� i n+ s. <br /> Storage Method,_ ;1QS++'C Vr,S ye ,f e- MATERIALS EVELOPMENT <br /> Contamination Noted - <br /> Storage Location -lit ,p a nSer��, <br /> Ip <br /> F[�r rn � �C C Casing type <br /> Blank ! I) ft:- Screen 20— ft. <br /> Slot size' 11 0. -0-20 <br /> GROUTING Bags cement S i v s <br /> bcntonite�_�.baun baa i <br /> Depth to water 2 3 Bags sarid/graveI_� soo loa a s y <br /> Mix Ratios S► - 4baAr 1$g 4 v Filter Pack type <br /> is /size 3 orf <br /> talIation Method r ti 1U,�,Surge Block;- Q/n ) <br /> Quantity Installed_S ;2-12rj d n ba—Ar a f •Discussed vntNgeologist: - Q/n ) <br /> EH292g. �or+ ' a_W Ceyniei � Type of I ctliod i�I e >Q!ac.�� <br /> -Tc�e- - s- TL 1 a w 1?11 R4 <br />