Laserfiche WebLink
MONITORING WELL INSTALLATION R£PP-T <br /> Date: ;;�" �,• r;"r <br /> CONSTRUCTION <br /> Premise Address:��` �� ��✓/Z' <br /> Total Depth <br /> Well No.: C�'L' '� � Screen Length (from) (to) <br /> Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: /( /t { Grout (from) (to) <br /> e *0061-7W Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: <br /> LIJ6G Completion - Stove pipe/chHstie box (circle one) <br /> Driller: _ casing <br /> Consultant height <br /> I <br /> Geologist -f:�1/�Cr /`'�, fL��ti _ T ; <br /> ABO VE-G R CUN D <br /> CO 1.P LET IO N CNRSTY-BOX <br /> SPECIAL PERMIT INFO. COMPLETION <br /> Ground Surface <br /> Distance to sewer line ' Grout <br /> Domestic well on site - (y/ n <br /> If yes, location and distance - ft. <br /> ft. <br /> ft. <br /> m <br /> = a <br /> _ m <br /> SAMPLING _ o <br /> /GC <br /> 110 ad _ c soc�on <br /> Holding Temperature �l _ <br /> Method = Qravet pack <br /> Screening Method <br /> Tracking Sheet - (y/ n ) _ <br /> SPOILS <br /> Storage Method M_ ATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft. Screen <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/ n ) <br /> EH 29 29 <br /> Type of method <br />