Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> i' <br /> 11 <br /> u <br /> Date: CONSTRUCTION <br /> Ij <br /> i <br /> Premise Address:Z G 1 ;3 well. No. <br /> Inspector: Total Depth <br /> Screen Length ! <br /> Filter Pack_ � L <br /> Bentonite Pellets 465 <br /> Permit No. Grout11 <br /> Consultant- -6C-, Completion-Stove pipe christie box <br /> Geologists> ,_, ,IJLu.Z , ,--- II � <br /> ( — <br /> Auger{,O.D, rU% <br /> i -, <br /> Auger I I.D. A f <br /> SAMPLING <br /> Holding Temperature elk*-,p <br /> Method_N&&t -Ta A,, <br /> Screening Method ' T <br /> ABOVE-GROUND CHRISTY-BOX <br /> Tracking Sheet {y nj COMPLETION <br /> COMPLETION <br /> Ground Waco <br /> SPOILS <br /> 9rooA <br /> Storage Method ' <br /> Contamination Noted - yes n )' <br /> Storage Location_ a,�-'� n• <br /> SPECIAL PERMIT INFO. <br /> C <br /> A: a <br /> Distance to sewer line aecvon <br /> Domestic well on site -�/no -= <br /> If yes, location & distance <br /> ;.tt. ft. <br /> b <br /> GROUTING 1 <br /> MATERIALS USED; <br /> �?r11 T <br /> t� <br /> Depth to water O"f*L�1 Casing ,type Py& - _ <br /> Mix Ratios MP Blank!C-? ` ft. Screen (3-1q ft. <br /> Installation Method tie � Slot 'size .6-Lo <br /> Quantity Installed 4G�J3 Bags cement L2 r <br /> Buckets bentonite <br /> Bags sand/gravel O <br /> Filter Pack type/size <br /> 1-244V �j <br /> shy � ��e•i,, d� O�d� �" �_�` U <br /> 1 <br />