Laserfiche WebLink
MONITORING',VUL INSTALLATION RI=POTI' <br /> Date: 2 (� t CONS t RUCTtOti <br /> Premise Address: � � "` total Dcpth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector. •���� Grout (from) (to) <br /> .Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/c-HHstie box (circle ore) <br /> Drilling Company: <br /> Driller: ca�iag <br /> consultant ���� <br /> C <br /> ave � ct�r�D <br /> c•�/-'���:srr-max <br /> SPECIAL. PtRATi l INFO. C-r=d SU!. <br /> DistanceIL-ie <br /> to sever � <br /> Tln :ntr t.' c ( 5�/ ) _ - ...._....... <br /> _ri <br /> If yes, location and distance - <br /> #I. <br /> 0 <br /> - M <br /> O <br /> ISA.WLING xlas ai E <br /> sac;cn <br /> Holding Temperature <br /> Method <br /> Screenin;Method <br /> Tracking Shcet - ( y/ n ) <br /> II• <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft: Screen <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bcnton'ste <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> imudlation Method Surge Block: - ( y/ ii ) <br /> Quantity Installed Discussed vrith geologist: - (y/ n) <br /> Type of ractliod <br /> EH 29 29. - <br />