Laserfiche WebLink
OAONITORING WELL INSTALLATION RE T <br /> Date:_;�« <br /> CONSTRUCTION <br /> Premise Address:_ G, r Q t <br /> nn A� Total Depth <br /> Screen Length (from) <br /> Well No.: Filter Pack (from) (to) y 2 <br /> Inspector- Bentonite (from) (to)_fT <br /> P C Grout (from) --Q- (to) <br /> f <br /> Permit No. D Drilling rig type <br /> Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (cir— cle one) <br /> Drilling Company: I.t��� � <br /> J <br /> Driller._ P <br /> Y_ casing <br /> height <br /> Consultant 5(--ccf z <br /> Geologist_ <br /> ABCVE-GAC(JND <br /> CO kV L_RION C_-GZ TY-6ox <br /> SPECIAL PERMIT INFO. CCMPLt-T1CN <br /> Oru:rd5Lrfrr <br /> Distance to sewer line gran <br /> Domestic well on site - <br /> If yes, location and ance - �_{t• <br /> �L h. ft. <br /> a <br /> SAMPLING = o <br /> tlorad — c <br /> Holding Temperature1°`"n _ <br /> Method L <br /> Screening Method 1 I = <br /> Tracking Sheet - "ny ) <br /> SPOILSft. ft. <br /> 6cv,}okc�{• �� 6� _L�n„tia� <br /> Storage Method MATERIALS/DEVEI.OPMENTS r <br /> Contamination Noted - n ) <br /> Storage Locationrp,5t <S <br /> m tSiS Casing rype_L Sf AjN p, 1 <br /> Blank 7_-I' +o}u.P. ft. Screen <br /> GROUTING Slot size gs cement,CLn k jn�C�.P t. t <br /> Depth to water v Z,x� Buckets bcntonitea <br /> Mix Ratios Bags sand/gravel <br /> n/ z.S,a� Filter Pack type/size <br /> Installation Method Surge Block: - Qy n ) <br /> Quantity Installed p <br /> Discussed with eologisr. •©/ n ) <br /> EH 29 29 Type of method <br />