Laserfiche WebLink
M?AGE 3 OF <br /> .. MONITORING WELL INSTALLATION REPORT <br /> Date: .1ry CONSTRUCTION <br /> Premise Address: Well No. % , <br /> Inspector: Total Depth "Z <br /> Screen Length 77 - 7 -2 <br /> Filter Pack 7 2 <br /> Bentonite Pellets_ <br /> Permit No. �' �� S Grout 7� <br /> Consultant Completio -Stove pipe hristie box <br /> Geologist i r•��, /ti,F <br /> Auger O.D. <br /> Auger I.D. <br /> SAMPLING <br /> Holding Tem erature /«,�� addrup <br /> Method ' 7 1, 154'c <br /> Screening Method <br /> ABOVE-GROUND CHRISTY-BOX <br /> Tracking Sheet (yez- COMPLETION COMPLETION <br /> �.�.��•Orourd Sulaco <br /> SPOILS <br /> glowStorage Method �������� <br /> Contamination Noted - yes/no <br /> Storage Location_ <br /> Gail 5� <br /> = o <br /> SPECIAL PERMIT INFO. _ <br /> o <br /> slonad <br /> Distance to sewer line sectan <br /> Domestic well on site - yes/no <br /> gmvW pack <br /> If yes, location & distance - <br /> GROUTING <br /> MATERIALS USED: <br /> i <br /> Depth to water �C�' y Casing type <br /> Mix Ratios Blank ft. Screen Z GJ ft. <br /> Installation Method Slot size c'> <br /> Quantity Installed Bags cement <br /> Buckets bentonite 475- <br /> Bags <br /> 75Bags sand/gravel <br /> Filter Pack type/size _ Z- <br /> Total Billed Time Per Site <br /> Date Permit Finalized <br />