Laserfiche WebLink
A. <br /> - MONITORING WELL INSTALLA'T'ION REPORT <br /> [ hn i3 <br /> '�r 3 D3 CONSTRUCTION <br /> Date: m h <br /> r Total Dcpth•_ <br /> Premise Address: 4 Screen Length (from) S e (to) Z 5 <br /> Filter Pack (from} (to) .23 <br /> Well No.: M W Bentonite:, (from) 23 (to) 1 <br /> Grout (from) t to) <br /> Inspector. `� E Drilling rig type E <br /> Auger O.D. LD. <br /> Permit No. 3 3 $8 Completion - Stove pipe/cliristie box (circle one) <br /> Drilling Company: <br /> r casing <br /> Driller: To ri i a rn f l b height <br /> rr 4 <br /> Consultant AdVayle.-e-d <br /> G66 <br /> } <br /> Geologist Vjham MOVE,.GHCUND <br /> CO&PLETCN C>�tSTY-cOX <br /> � mer+ <br /> act <br /> SPECIAL PERMIT INFO.$ <br /> Lrf <br /> ,p pro I <br /> Distance to server line � <br /> Domestic well on site - (y/ n} ' I ft• <br /> If yes, location and distance - 3 n• <br /> SAMPLING <br /> s to t•.kd <br /> P <br /> f sac�cn <br /> N <br /> Holding Temperature A ` _ gave Pack <br /> Method <br /> Screening Method <br /> Tracking Sheet - (y/ n) 1i —° ,• fi• <br /> SPOILS :6 <br /> Storage Method a I OT r u rn.S MATERIALS/DEVELOPMENT <br /> Contamination Noted - y/ n) <br /> Storage Location Py <br /> += � Casing type 2 i n� S �e.dr1�e 46 <br /> BIank � .25 ft- Screen �D ft. <br /> Slot size D 2 0 i n S <br /> e <br /> GROUTING f3a�s ment <br /> E�s bentonite + i s <br /> Bags Sand gravel s <br /> Depth a water # <br /> Mix Ratios G1 u ?' + 11 an s Lja, �' Filter Pack type/size <br /> Installation MethodFr ] Surge Block: - g <br /> Quantity Installed Discussed with geologist: - n) <br /> _ T3ype of;mcthod <br /> It <br /> EH 29 29 <br /> Ib <br />