Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion- Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: c as ing <br /> height <br /> Consultant <br /> Geologist <br /> ABOVEGROUND CHRSW-BOX <br /> COWLErION COMPLETION <br /> SPECIAL PERMIT INFO. around Siebe <br /> Distance to sewer line Qf0ut <br /> Domestic well on site - (y/ n ) tt <br /> If yes, location and distance - <br /> . R. <br /> R. _ <br /> q <br /> O <br /> SAMPLING alattad <br /> aec5on <br /> Holding Temperature = V94 Pack <br /> Method <br /> Screening Method I= <br /> Tracking Sheet - (y/ n ) <br /> SPOILS <br /> Storage Method MATERIALS�EVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - (y/n) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />