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Date: l0-LZ 72 CONS-I-RUCTION <br /> Address: Tocal Depth lS` <br /> / / Screen Le.^.rh (F-om) C,5q (to) k <br /> Well bio.: L7-3 ::Iter ?ack ("Orn) 3' ( (to) 'T 7.5- <br /> Bentonite (from) 1*- 75 (to) S . <br /> Ins-0ec:or: Grout (tom) 5• (to) D <br /> �} Drlling rig type •SSS <br /> ?e.rmic No. Auger O.D. (Q • I D. <br /> Compledorn - Scove pipe/c:Zrsce box (circle one) <br /> Dr?l:ng Company: l�F <br /> cas-Ing <br /> _ <br /> D iter �p�n� t he:gr.t <br /> ♦� IV <br /> Cor.sultazr <br /> Geologist �Q p,11 � �.30VE GACL:ND <br /> ccMrILET CCN COMP' —41CN <br /> Groc:nd S�s',xi . <br /> S?EC'A ?ERVIIT INFO. <br /> Distance to sewer line <br /> E., .estic wet on site - ( y/ r, ) -7 <br /> If•ves, location and distance - <br /> Holding Temperature <br /> ate:.^od '== <br /> Screening Me:aod - _ <br /> Tracking Sheet ( y/ n ) !3-S Vii- ♦ = 7 if� <br /> • /3• <br /> S?OILS <br /> Storage Method r- 5 S� LGITBRIALS/DEV'L OP!�fEN7 <br /> Cor-,amination Noted - �n ) � � PI <br /> Storage Location M": G <br /> �� LI�P'� Casing type 2 •1 <br /> Blank 9 ft- Screen S ft: <br /> Sloc size 01 <br /> GROUPING Bags cement /'z <br /> Buckets bentonite a- 3 <br /> Dench 'o water -75 Bags sand/gravel 2 <br /> Stix RadosG o�0 7 2 - F1ter ?ack type/size <br /> Ins:a11aron Me='-od Surae Block: - ( y ) <br /> Quar.r:^r :ns called V3 7�) Discussed wic;h geo ogisr: - ( 7 -01 <br /> Type of:method <br />