Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> k <br /> Date:- Z� �,yUCONSTRUCTION <br /> Premise Address:Sty v�JYG� Well No. /'� y✓ <br /> Inspector• Total Depth Z S - <br /> q i Screen Length S' <br /> Filter Pack <br /> Bentonite Pellets <br /> Permit No. C� Grout_ <br /> Consultant 4/n(/`eA Completion-Stove pip chrietie box <br /> Geologist f ri - <br /> Auger O.D. 7 <br /> /�/ Auger I.D. 3 7— <br /> i SAMPLING .._ _. .__— —. <br /> Holding Temperature �tickyP <br /> Method <br /> Screening Method <br /> ABOVEGROUND CNRISTY-BOX - <br /> Tracking Sheet (y/n) COMPLETION COMPLETION <br /> SPOILS <br /> Storage Method <br /> Contamination Noted - ye� <br /> Storage Location <br /> SPECIAL PERMIT INFO. = c <br /> o <br /> do:wd = c <br /> Distance to sewer line myon B <br /> Domestic well on site t-yeamo _ gmvwP&* <br /> If yes, location & distance <br /> r = � <br /> GROUTING <br /> MATERIALS USED; I/ <br /> Depth to water / casing ty �y C <br /> Mix Ratios Blank ft. Screen_Z_ft. <br /> Installation Method Slot size <br /> Quantity Installed Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel Z <br /> Filter Pack type/size <br />