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Dace: 49-eWOze,9 <br />Addr=-: 12,// AJ 1446/ <br />wtn -21.0(12-- (841•2-1 ) <br />Laspecron <br />Per:-...it No. <br />DrMing Company: <br />" • o2 3 / <br /> <br />Driller 2 üy 0-0 / <br />C.onstamnr f0.53777'7ce_ <br />• <br />SPEC.A.I. ?ER IT INFO. <br />Dismnct to sewer <br />Domesric well on site -(y /0) <br />If yes, location and dismact - <br />(eDt <br />—.A.. 5o <br />SAMPI_ING <br />Holding Tem <br />Method --"`erregl <br />Sate:ling Method b <br />Traeg Sheet - a ) <br />4.6 c. <br />casing <br />heighz <br />4-0 <br />SPOILS <br />GROUTING <br />Depth co wa ez- <br />Nrc.: Rados <br />Ins-alladon Method <br />Quanci:y thsmaeri <br />6 <br />ItO <br />55 Storage Method <br />Con,-27-4rAtion Noted - <br />Storage Location 611- <br />) s'o • <br />MO, SING WELL INS7...;LI—A.7.C4 REPORT <br />CONSTRUCr.TON <br />Total Depth 6-c) <br />Sa•ten Length (from) 0 (co)_ <br />Eat= Pack (from) 3 (to) <br />Bentonite. (from) 36) (to) <br />Groot (E-ora) 3 (to) Pr <br />Drilling rig type CIME, <br />Atcger (cg. LD. `i <br />c..amplerion - Stove pipe/±riszie box (&-cle one) <br />MATIRLALS/DEVELOPNStir <br />Casing type Li <br />Blank 40 ft. Sceen Zdel <br />Slot size ,0 <br />Bags =le= <br />Buece= bentonite <br />Bags sand/g--avel <br />En= Pack type/size <br />Surge 31oc. -C y <br />Discnssed with geolor:s7-' • (y 0 <br />Type of method <br />ft.