Laserfiche WebLink
MONITORING WELL INSTALLATION REP* <br /> Date:_ I I/. / O CONSTRUCTION <br /> Premise Address: l Total Depth 3`�lz t <br /> Well No.: L VL�W"` m ` �s Screen Length (from) /9 t z (to) <br /> Filter Pack Mom)_(y<(to)_ �� <br /> Bentonite (from)_ I s (to) <br /> Inspector, l lam, �� - Grout (from) $ (to) —1T— <br /> Drilling rig type <br /> Permit No._ Auger O.D. I.D. <br /> Completion - Stove pipe/diristie box (circle one) <br /> Drilling Company:_ W c.,-F lam, d�_ <br /> Driller: casing <br /> he; <br /> Consultant 0 t <br /> Geologist <br /> A80VEGACUND <br /> CO AV LETCN c4.0:SiY-aOX <br /> SPECIAL PERMIT INFO. COMPL`nCN <br /> C',<rwwr4 Strfra <br /> Distance to sewer line grcvt <br /> Domestic well on site - (y/ <br /> If yes, location and dist e - I �//.L _Z —J_'_ft. <br /> A&V ft. <br /> — m <br /> = o <br /> SAMPLING — o <br /> ►lorni — c <br /> tocicn <br /> Holding Temperature = <br /> Method _- = p,vdpacx <br /> Screening Method = <br /> Tracking Sheet - ( y/ n ) <br /> a9�z = 35rZ <br /> _ft. <br /> SPOILS <br /> Storage Method 01' p( C.✓a� Lc , MATERTALS/DEVELOPMENT <br /> Contamination Noted - (y/(0) �y <br /> Storage Location o f ¢ kl illj..,.,�r. .M yr- Casing type Z v(b <br /> Blank 2 �ft. Screen _ft. <br /> GROUTING Slot size vzo <br /> Bags cement <br /> Buckets bentonire <br /> Depth to water_ nJ �c t Bags sand/gravel _ <br /> Mix Ratios Filter Pack type/size a !Z�' <br /> Installation Method Surge Block: - ( y/(.f ) <br /> Quantity Installed Discussed with georo'gist: - ( y/0 <br /> EH 29 29 Type of method <br /> � [C �[ol • ,I,wv- 8 • <br />