Laserfiche WebLink
#NITORING WELL INSTALLATION REPO* <br /> Date:_ �� CONSTRUCTION <br /> Premise Address: �Sr�` b 0 � �,�� �4 � Total Depth � J <br /> Well No.: I I' I I 7 Screen Length (from) . 9 `/,— (to) <br /> Filter Pack (from) jSn (to) 3�— <br /> Bentonite (from) I (to) �I <br /> Inspector w Grout (from) (to) <br /> 3 lJ Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Com an � Completion uistie box (circle one) <br /> Driller: casing <br /> height <br /> Consultant <br /> Consultant Oz . I <br /> Geologist <br /> ABOVE-GROUNDa�'l COA�LETION CHA1STf-BOX <br /> SPECIAL PERMIT INFO. Ciroundgurran COMPLEnON <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - <br /> 2 (t, <br /> N.. <br /> — e <br /> SAMPLING dora9 - c <br /> seclen <br /> Holding Temperature <br /> Method — gnvd Fade <br /> Screening Method <br /> Tracking Sheet - (y/ n ) " <br /> /�� - ft. 15 M <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) „ 9 u <br /> Storage Location Casing type 4 <br /> Blank I L[ () ft. Screen ICJ ft. <br /> Slot size <br /> GROUTING Bags cement 7:7 <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Rados IJ biz Filter Pack type/size <br /> Installation Methd Surge Block: - (y/ n ) <br /> Quantity Installed d Discussed with geologist: - (y/ n) <br /> EH 29 29 Type of method <br />