Laserfiche WebLink
MONiTORINGVMI.L INSTALLATION REPORT <br /> Date:—_-' $ I SIT(„ _ CONSTRUCTION <br /> Premise Address: x• <br /> _. _ 3.0 C&n:r Total Depth_ - 7 <br /> Well No.: Y%No- Screen Lengrh (from) ; (to)�` <br /> _-. Filter Pack (from)_ > ;; <br /> Bentonite (from) I rl (to)___?_A t <br /> Inspector. _ - _ o•. _. _ Grout, (from) (to) ^ <br /> lL <br /> Permit No. +- <br /> _ 4 -49 3 S' Augersg rig type <br /> ... .�. Auger O.D. I.D. <br /> Completion - Stove Pipe/clzristie box (circle one) <br /> Drilling Company: {/ v»n-•� ' <br /> Driller 1 <br /> casing. <br /> height <br /> ConsultantF `�' <br /> msec d - <br /> Geologist_ t''r�?T� .44 <br /> AZG VE-G R C(N D G�-R:�T'�'30X <br /> CO l4Q L.�Tfo N ALL-ncn <br /> SPECIAL PERMIT INFO. C' clyd Suixt <br /> Distance to sewer line flra-" <br /> Domestic well on site - n) <br /> If yes, location �stance - <br /> t S it. <br /> SAMPLING s •+ , <br /> sacicn <br /> Holding Temperature <br /> Method <br /> Screening od <br /> Trac Shcet (y/ n ) HE it. <br /> SPOILS, . <br /> Storage Method MATERIALS/DEVELOPMENT x <br /> Contamination Noted - y n) <br /> Storage Location_ a- a Casing type - i•{ PVC. - <br /> Blank of s ft. Screen Zd • <br /> F- Slot size ,O LO <br /> GFROLMNG Bags cernent <br /> Buckets bentonite 3 `t <br /> Depth to water ' N 7- Bags sand/gravel . <br /> Mix Rados 6 Filter Pack type/size 7- <br /> iAstallation MethodSurge Block: - (y/(1-31 ) <br /> Quantity Installed O - 6` Discussed with geo ogist: <br /> - Type of riactliod <br /> EH 29 29• dvv 56CA-1 <br /> rlr ' <br />