Laserfiche WebLink
!� 4' ''fONITORING WELL INSTAI i.ATION REp�--"'-^r �l f`' _ <br /> kw fi <br /> '•� ate: _ - - CONSTRUGTION <br /> e <br /> �' � <br /> Premise Address: 141 - x Total Depth -- <br /> een' gtYt-Eh�m� "" �rn1 <br /> r Well No.• rJ ~ Fitt ack { om (to) t <br /> to <br /> �( g p ) B tofu om <br /> Inspector. J� V�o '' F Grout'. (from to)^ <br /> Drilling rig type M D <br /> Permit No. -� -, Auger O D._ g %4 I.D. �'''* __ <br /> 1'errn _ TM Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller• F <br /> Consultant J 1� <br /> 1-sQ y <br /> GeologistCHR <br /> COWLETIONO-7r- <br /> 0 - OMPL ETION <br /> SPECIAL PERMIT INFO. �^ - �" Ground Surface <br /> l S grout <br /> Distance to sewer line �_��_ft <br /> Domestic well on site - {y/'n f.If'yes, location and distance - � ~ - � - '^ _' r. a ft, <br /> SAMPLING <br /> c ` T <br /> Holding Temperature r -. Vol <br /> Method > <br /> Screening Method 1 <br /> Tracking Sheet y 'nEL <br /> ) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT ' <br /> Contamination Noted - (y/ n) <br /> Storage Location�� in e <br /> � Bl ft. Screen ft. <br /> r ..:.. Ot s <br /> GROUTING Bags cement <br />• - - -- �. ru e <br /> Depth to water <br /> Mix Ratios U < 7size <br /> Installation Method S Block:Quantity Installed �- -Y D' cu d witist: - (y/ ne of EH 29 29 . , <br />