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S . <br /> Gu 4'!-eZ=ffeter 4A/4C •Form <br /> j Well Desig ation A10j-� <br /> Date It 2- 98' <br /> Inspector v. L. c� <br /> Page 3 of 5 <br /> 3) Sand Pack and Bentonite Seal <br /> a. Size of sand used to backfill hole? <br /> Reason size varied from that specified by Cotter <br /> geologist or engineer: CoLmRA¢io S,uCA SA10 <br /> b. Depth to which sand pack was placed? q Method <br /> j0 sc�.�ss sa p.� used to sound depth to top of sand pack:�' c pipe <br /> 5(L,. a-VJ5 (hamsvr <br /> Does sand pack extend 2 feet above top of screen <br /> interval? Yes ✓ No Reason sand pack does not <br /> extend 2 feet above top of screen interval: <br /> C. Size of bentor}ite chips or pellets used for seal above' <br /> sand pack? t + " -P�t,�ts <br /> LweLA�5 f IkA_5 d. Depth to which bentonite was placed? 6` <br /> Method used to sound depth of bentonte seal? <br /> 4) Cementation <br /> a. Volume of annular, s ce between well casing and hole wall- <br /> from top of benton a seal to surface? <br /> 'D(Q mat use��ur. .. , :. • •: <br /> TO F(LL AN1JULAR SFj*{. ::;:::,%.• tx ;`,-•. <br /> b. Emplacement o neat cement grout betwee/we' =casing and <br /> Ltseo ifpue.G�a.�•s borehole wal <br /> Volume of neat cement grout emplacReas for variation between vol nnular 7ace. <br /> W,L� !o fcX&Ar 0� and amount of grout emplaced: <br /> •�,;,�- .� �ek set <br /> ii Was . <br /> 5 ) grouting operation ntinuous? Yes <br /> Cadw�-9 No Reason for no -continuous empfa �ment: <br /> iii Was there a ret rn of grout to sur ace? Yes <br /> No Reaso for variation: <br />