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MONITORING WELL INSTALLATION REPORT <br /> Date: JUn 3Q 2Q0 OS CONSTRUCTION <br /> Premise Address: Total Dcpth1 <br /> Screen Length (from) /SU ' ([o) Q ' <br /> Well No.: AE Filter Pack (from) 1.170 ' (to) /78 ' <br /> Bentonite (from) -) 39 ' (to)_1 3S/ <br /> Inspector•. V ► Gk �r r 6--1 Grout (from) •3 (to) Sur — <br /> Drilling rig type E <br /> Permit No. Auger O.D. I.D. - 2� <br /> n ^ Completion - Stove ripe/ tristie boz circle on=_) <br /> Drilling Company:— ( ,/1 S :a Ci <br /> Driller: -Tori�y t�r� 1r�1 I� 0 - ria OQ�y casin <br /> ► <br /> ins j4ja- L4 rsvY•- / r/C�,i b6S F11 <br /> � he_ght <br /> Consultant_ 'Janee-d CeoEndi✓'oi2 e, +cal <br /> �' <br /> Geologist �e►'1 e ;YeA�Vc��CUND <br /> CO!vf'LET N Ck•A:STY-�X <br /> C-Om?LETICN <br /> SPECIAL PERMIT INFO. " <br /> grcx.; <br /> Distance to sewer line U►7 )42 b/.J n <br /> Domestic well on site - O n ) /3 f'. <br /> If yes, location and distance - ft. <br /> -- f <br /> SAMPLING �a Sb;"1 4 ryi�I c.S lvtre- ee 11 cG tfoca� <br /> C.Pt bo r, nc4rbrJ. fro ✓t� � 1;�h•lJg�. I c <br /> ccin <br /> Holding Temperature <br /> Method - _— <br /> Screenin-Method = <br /> TrackingSheet - ( y/ n ) _ <br /> I50 n, = Ir1so % <br /> SPOILS <br /> Storage Method V Is MATERIALS/DEVELOPMENT <br /> Contaminadon Noted - (y/ z" <br /> e Location Q si+L _ Casing type SGh�Av1 e <br /> Stora 4'0 <br /> g Blank /4-p ft. Screen /D <br /> Slot size 0102- -- <br /> GROUTING Bags cement 57.947 ,2 0 Port1�7 <br /> Buck-etsbentonite VAT Q-1 <br /> Depth to water 0-� Bags sand/gravel 7 bass 0bo -IL) t 3 — <br /> Mix Rados `I- o ert C�raewf'13D9g/hers Filter Pack type/size 3 <br /> .installation Method HZ° Surge Block: - (y n <br /> Quantity Installed b y7 Par f la,q/Discussed with geologist: - CY/ n ) <br /> ez` Type of method <br /> .290 14/r. ! <br /> EH 29 29 Qf uiat� <br /> �e 3 bit,+ ' f e- �e >�� PL v+?� <br /> Sa P'J <br />