Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: <br /> "_�Ct <br /> L �� _ CONSTRUCTION <br /> Premise Address: (05 �; 6�. •�-5 <br /> T-�''S,Pr•,� otal Depth <br /> Well No.: W ![" K Screen Length (from) <br /> Ir,Filtar Park (to) G <br /> Inspector: 0V T <br /> . � 001% Bentonite <br /> (from)6-0 (to) <br /> Permit No. Grout (from) D. f <br /> Drilling rig type i�.g (to) <br /> Auger <br /> 1` O.D•Drilling Company: g 2 i I.D. <br /> _00) peion StovP P / hdstie <br /> box (circle one) <br /> Driller: Dawe_ <br /> 0.N t/ <br /> Consultant casing <br /> height <br /> Geologist <br /> _Q�N <br /> A-SOVE-GROUND <br /> SPECIAL PERMIT INFO. CCWLETCN <br /> Ground Suri3ca COfYfPLI�^•, <br /> Distance to sewer line p <br /> Domestic well on site - (y Grout <br /> If yes, location and distance l l <br /> 14�ft. <br /> b <br /> SAMPLING — m <br /> slotted � <br /> Holding Temperature svc5on = <br /> Method = <br /> ScreeningMethod N A 71''�Pack <br /> Tracking Sheet - (y/n) � <br /> SPOILS ft• <br /> Ic 5 ft. <br /> Storage Method_ Brvv t S <br /> Contamination Noted - 4.y MMATERIALS/DEVELOPMENI' <br /> Storage Location_ M.0 p <br /> Casing type 1 VC <br /> Blank ft. Screen to <br /> GROUTING Slot size_ p.,wt p�i —ft. <br /> f Bags cement <br /> Depth to water Buckets bentonite <br /> Mix Ratiosr A Bags sand/gravel 4 S <br /> Installation Metho °Q�— Filter Pack type/size <br /> Quantity Installed Surge Block: - �n ) <br /> logist: - <br /> Discussed with geo / n ) <br /> EH 29 29 Type of method <br />