Laserfiche WebLink
y MCfORING WELL INSTALLATION REPORT <br /> --47 CONSTRUCTION Well No.. <br /> - <br /> Date:—y�bU-f- L t� <br /> O� 1 Total Depth (to) <br /> premise Address. Screen Length m) <br /> Filter Pack (from) (to) <br /> Well No.: Bentonite (from) < L (to) <br /> Grout (from) L (to)n <br /> InspectoF /�1Al��r.G� frig-�— <br /> r C ' OIZ Auger O.D. <br /> Permit No. /N[ Completion cove pipe/chrisae box (c role one) <br /> Drilling Company Well No.: <br /> CONS <br /> Driller. II ( 5 <br /> Total Depth (to) 3 <br /> Consultant Screen Length (from <br /> (to) <br /> Filter Pack ( (to) <br /> Bentonite (from) (to)Q�- <br /> Geologist (from) t( <br /> ( <br /> Drilling rig me I.D. <br /> SPECIAL.PERMIT INFO. Auger O.D. de box ( irde one) <br /> Completion cove pip <br /> Distance to sewer line <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance - CON�Well No.:� <br /> g � Total Depth (from) O (to) ` <br /> ?] <br /> Filter <br /> Length ( 1 (to)-- <br /> •`�- � Filter Pack (from) <br /> (to) <br /> SAMPLING / vBentonite (gym) (to) � <br /> ��� 0c rout (from) <br /> 1 ._-`ung ngpe I D. <br /> Holding Temperature Auger 0-D <br /> Methodove tel ne cle one) <br /> Completio <br /> Screening Method <br /> Tracking Sheet - (y/ n) <br /> EOILS <br /> rercetai S/DEVELOPMENT <br /> Storage Method <br /> Contamination Noted - (y/ n) Casing type <br /> Storage Location Blank�fr. Screen_�— <br /> Slot size <br /> Bags cement <br /> GROUTING YhU7 Buckets bentonite <br /> Bagssand/gravel <br /> Depth to water Filter Pack type/size <br /> Mix Rados Surge Block: - (y./ n) <br /> installation Method Discussed with geologist: - (y/ n) <br /> Quantity Installed Type of method <br /> EH 29 29 <br />