Laserfiche WebLink
WE / OF <br /> MONITORING WELL INSTALLATION ke1I�,�I,,� <br /> Date: Je2 _ CONSTRUCTION <br /> Lj <br /> Premise Address: c��-'�-� ��sm�'� We11 No. <br /> T T� <br /> Inspector• Total Depth SO <br /> Screen Length---! ® <br /> Filter Pack <br /> Bentonite Pellets 26- 23 <br /> Permit No. �y ^ Z Grout <br /> Consultant e Completion tove pipe christie box <br /> Geologist <br /> Auger O.D. <br /> Auger I.D. <br /> SAMPLING <br /> stldcup <br /> Holding Temperature <br /> Method <br /> Screening Method <br /> ABOVE-GROUND CHRISTY-BOX <br /> Tracking Sheet (y/n) COMPLETION Op+,�pLETION <br /> Grourd Surface <br /> SPOILS Oren <br /> Storage Method f014 5 _ <br /> Contamination Noted - yes/no ft. <br /> Storage Location <br /> Dn 'z 1 e ne <br /> 4✓r9 �S'� = a <br /> r <br /> SPECIAL PERMIT INFO. - o <br /> sectio = S <br /> Distance to sewer line_ moo^ =_ <br /> Domestic well on site - yes/no yravelpack <br /> If yes, location & distance - <br /> ft <br /> GROUTING <br /> MATERIALS USED: <br /> Depth to water Casing type <r✓Pen S +rnIe55 <br /> Mix Ratios Blank 6L/C- ft. Screen 2 o ft. <br /> Installation Method Slot size CG <br /> Quantity Installed Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel <br /> r <br /> Filter Pack type/size / <br /> Total Billed Time Per Site 371, 19 4c All eA{yq e/7v✓+5 G✓e �PPS <br /> Permit Finalized 4, o <br /> r b7 ' <br /> Date �_ac�' SL—_ � '^���� "-Y <br />