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WeIITConstruction Details' Well Name: ,, /� LJ- g <br /> (Permanent Well Name) <br /> nq Numbo Installation Supervised by:T l,aQe <br /> r__^e Well Type: EXW VAP VIEWIlatioq Date Project , t1 1x_kbQ t OBS PZ TST Other: <br /> (Circle only one choice) <br /> Location Proximity � Location Desafiption: r 4�� <br /> 3 Company (Inside or Outside Facility) ��++ <br /> Geohydrologic Zone: <br /> `] ❑Aquifer I <br /> ruction Method 619 ❑Confining Lay <br /> or or Agviclude <br /> U Lowar or Conrined Aqulter <br /> JkC tY Perched Aqulfer Measuring Point Location(i.e.TOC) <br /> Unsaturated Zone <br /> 9 Method(if different) 1Natcr Table Aqulfer <br /> Surface CompletionTypelqr Ground Surface Elevation <br /> 3 Well Details <br /> Type/Amount of Grout CasingTy <br /> r: Gallons of Water 51 <br /> —� <br /> and Amount <br /> is Address Sacks of Cement <br /> Casing Diamete(y <br /> Pound of Bentonite <br /> � Centralizer Spacing <br /> is Telephone: <br /> Type/Amount of and Number Used <br /> Bentonite Seal <br /> _�� ----L� <br /> ✓ey Data Top of Bvctonite Seal .r-.:9(. <br /> ng <br /> ��Top of Sand Bridge <br /> Type/Amount of Sand Bridge <br /> g Top of Sand Pack <br /> Type/Amount of Sand Pack l f <br /> for Coordinates Top of Screen <br /> I a E t <br /> Screen Type and Length <br /> inate System Filter Pack Length{ <br /> wing Point Elevation Screen Slot size Bottom of Screen <br /> L03 �^ a <br /> y Company <br /> Screen Diameter Total Well Casing Depth <br /> r <br /> Screen Percent Open �. <br /> Borehole❑{fimtrter�� Borehole De th <br /> 1 Date Screen Material <br />