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Well-Construction Details' Well Name: 1. �—Z <br /> (Permanen[Well Name) <br /> ng Numb.er Installation � <br /> rh Supervised by:T[,ate t- <br /> Well Type: EXW VAP VEW <br /> Iatip Q Project t OBS PZ TST Other: <br /> 1 (Circle only one choice) <br /> Location Proximi Location D05GfiQtlflri' •-�� <br /> 1 Company (Inside or Outside Facilily) <br /> Q&kt`A� Geohydrologic Zone: <br /> ❑Aquifer <br /> ruction Method n ❑Confining Layer or Aquiclude <br /> [I Lower or Confined Aquifer <br /> ❑Perched Aquifer Measuring Point Location(i.e.TOC) <br /> ❑Unsaturated Zone <br /> j Method(if different) ❑Water Table Aquifer <br /> Surface Completion Type Ground Surface Elevation <br /> Well Details <br /> Type/Amount of Grout: Casing Ty �/o Vc <br /> Gallons of Water _ IsC_] <br /> and Amount <br /> rs Address Sacks of Cement <br /> ' U). Casing-Diameter <br /> Pound of Bentanite <br /> Centralizer Spacing ` <br /> is Telephone: <br /> Type/Amount of <br /> Bentonite Seal and Number Used <br /> fey Data �'�,..— ,• • 4 -4f--Top of Benton to Sea[ <br /> ng <br /> _ -.*—�Top of Sand Bridge � hI <br /> Type/Amount of Sand Bridgo '^ <br /> '$�f'. <br /> 9 �, <br /> ��—Top of Sand Pa <br /> T po/Amount of Sand P <br /> or Coordinates Top of Screen <br /> Screen Type and Length 1 <br /> inate System ,{ a G 1 Filter Pack Length <br /> iring Point Elevation Screen Slot size Bottom of Screen <br /> Screen Diameter <br /> f Company C L Val Wall Ces17g Depth <br /> Screen Percent Open <br /> Borehole Di�lmeteF~~ Borehole.Deptll <br /> Date Screen Material ^� <br />