Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> t b _ <br /> Date. �l/fid/ �4 CONSTRUCTION <br /> Premise Address: l� { Total Depth <br /> Screen Length (from) 4 (to) 1 <br /> Well No.: Filter Pack (from) (to)40 <br /> Bentonite (from) (to) <br /> Inspector. �Fd7C/ _ Grout (fromb (to) <br /> Drilling rig type PS <br /> Permit No. Auger O.D. R�, " _ I.D. <br /> Completion- Stove gipe/christie box (circle ane) <br /> Drilling Company: ✓j-�e k&, <br /> [I Drillercasing �- <br /> height <br /> Consultant f <br /> Geologist ABCVE,yROUyD <br /> CC&PL_EMON Ct4RtSTY-80X <br /> SPECIAL PERMIT INFO. s�""� <br /> J QrocR <br /> Distance to sewer line <br /> Domestic well on site - (y/ n } 'Z-� fL <br /> If yes, location and distance - - tL <br /> fi. <br /> M:. <br /> v` O <br /> ?. a <br /> ,t• C <br /> SAMPLING sbitAd ;, <br /> i � <br /> sacran w _ <br /> _ <br /> Holding T eratucam <br /> re <br /> Method ^u-✓? ' _ <br /> Screening Method <br /> Tracking Sheet - / n } _ <br /> w tL <br /> SPOILS �Q <br /> Storage Method MATERIALS/DEVEL.OPMEIVT <br /> Contamination Noted - (y/ n ) F f — Z <br /> Storage Location Casing type <br /> Blank f[. Screen. fr- <br /> Slot size 0,0 2.0 <br /> GROUTING Bags cement <br /> I i Buckets bentonite 2 <br /> �� Bags sand/gravel <br /> Depth to water, Filter Pack typesize <br /> Mix Ratios Surge Block: - (�►/ n) <br /> Installation Method <br /> Quantity Installed Discussed with geologist. - / n) <br /> Type of method <br /> EH 29 29 <br />