Laserfiche WebLink
(-,ONITORING WELL INSTALLATION REPe j <br /> Date:- 3 1 CONSTRUCTION <br /> Premise Address: S Total Depth r <br /> Screen Length (from)_ � /r (to) 3� <br /> Well No.: Filter Pack (from) -73 (to)� <br /> Bentonite (from)�a _(to) a 5 <br /> Inspector. A A i Grout (from) As, ( (to) <br /> 3 b Y Drilling rig type <br /> Permit No. <br /> Auger O.D. I D. <br /> Drilling Company:. c& <br /> SIC-1C Completion - Stove pip stie bo (circle one) <br /> Driller: casing <br /> height <br /> Consultant W7:FGeologist <br /> ABOVE-GRCUND CHRM Y43OX <br /> OOMPLErION COMPLETION <br /> SPECIAL PERMIT INFO. - Orcutd Su1an <br /> Distance to sewer line <br /> Domestic well on site - (y <br /> If yes, location and distane - fM <br /> SAMPLING ' <br /> &*clan x = <br /> Holding Temperature <br /> gra Pack <br /> Method <br /> Screening Method /_ U <br /> n <br /> Tracking Sheet <br /> tL <br /> SPOILS <br /> Storage Method 1 _ _ �_ _ MATERIALS/DEVELOPMENT <br /> Contamination Wted . y n / <br /> ) \ f <br /> Storage Location c Casing type 4 V <br /> Blank ft. Sgreen ft. <br /> Slot size <br /> GROUSING j Bags cement <br /> Buckets bentonite <br /> Depth to water — _—__ Bags sand/gravel <br /> Mix Ratios _ __ Filter Pack type/size <br /> Installation Method _- __ Surge Block: - ( y <br /> Quantity Installed ___- - Discussed with geo ogist: - (y/ n) <br /> Type of method <br /> EH 29 29 <br /> �O 0- <br />