Laserfiche WebLink
MONITORING WELL INSTAI LP`TION SORT <br /> CONSTRUCTION <br /> Date: <br /> Total Depth (to) <br /> Premise Address: Screen Length (from) <br /> Filter Pack (from) (to) <br /> Well No.: Bentonite (from) (to) <br /> Grout (from) (to) <br /> Inspector. i/ l Drilling rig type <br /> Auger O.D. I.D. <br /> Permit No. Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> casing <br /> Driller- —:F height <br /> Consultant <br /> Geologist ABOVE-G RCUND clunzTY-E= <br /> CoNgLETfON CQ&{PL T1CN <br /> Cirnund SurTaat <br /> SPECTAL PERMIT INFO. Qrc.K <br /> Distance to sewer line __,ft. <br /> Domestic well on site - (y/ n) ft. <br /> If yes, location and distance - <br /> O <br /> SAMPLING socicn - <br /> Holding Temperature <br /> Method <br /> Screening Method <br /> Tracking Shcet - (y/ n) tt. <br /> ft F � <br /> SPOILS <br /> — MATERI ALS/DEVEI.OPMENT <br /> Storage Method <br /> Contamination Noted - (y/n) Casing type ft. <br /> Storage Location Bl fc. Screen <br /> Slot size <br /> Bags cement <br /> GROUTING Buckets bentonite <br /> �• � Bags sand/gravcl <br /> Depth to water Filter Pack type/size <br /> Mix Ratios Surge Block: - (y/n) <br /> installation Method Discussed with geologist: - (y/ n) <br /> Quantity Installed Type of metliod <br /> EH 29 29 <br />