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MONITORING WELL INSTALLATION RF-PORT- <br /> Date: <br /> EPORTDate: CONSTRUCTION <br /> Premise Address: Total Depth 5 <br /> w— /�� Screen Length (from)' r7 c ao (to) L /i,s-n <br /> Well No.: Filter Parc <br /> (from) L Zr7 (to) l.a1 iss <br /> Inspector: -�p(BY.N✓\ <br /> Bentonite' (from) 1 C <br /> Grout (from) ,- (to) E 3 s— <br /> Drilling rig type --0,-42 /10rA/11✓ <br /> Permit No. Auger O.D. j n I.D. <br /> Drilling Company: <br /> Completion- Stove pipe/chnstie box (circle one) <br /> C�S��/�/�. rrwtsiT��ti s��r� - — •� ? ' <br /> E�'. .� <br /> Driller: 5 T6✓�v LFSG�� casing <br /> height <br /> Consultant <br /> Geologist <br /> ABOVE-GROUND CNA15?Y-80X <br /> CONPLE ON <br /> SPECIAL PERMIT INFO. Gmur)d Surix" COMPLETION <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance - <br /> ' �J d• 12�. <br /> ?(D ft. <br /> C <br /> SAMPLING <br /> s b tied f. — <br /> • <br /> Holding Temperature ;N <br /> Method vzvW sack <br /> Screening_ Method_ <br /> Tracking Sheet - y/n) <br /> 1664 Iso. " l tt. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location Casing type ST/dr�v�� ss <br /> Blank 7o ft. Screen_ <br /> Slot size p C i 0 <br /> GROUTING Bags cement S:o BcPCc!4 <br /> Buckets bentonite /0 <br /> Depth to water Bags sand/gravel- 26 Q MY.^ <br /> Mix Ratios Filter Pack type/size 2 i <br /> Installation Method __- ___ __ ____ _Surge Block:-- <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> EH 29 29 Type of methodr_ iLo eomQV <br />