Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: -t'T CONSTRUCTION <br /> Premise Address: Total Depth l� <br /> Screen Length (from) (to) <br /> Well No.: '2 Fj Filter Pack (from) Ab (to) 33-31 <br /> Bentonite (from) 3 1 (to) 2 <br /> Inspector: Grout (from) (to) <br /> Drilling rig type —T <br /> Permit No. ��6 ZZ Auger O.D. r ', I.D. <br /> Completion tove pie hristie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant I' <br /> Geologist <br /> ABCVE-GRCUND <br /> COMPLETION CHRLM-8CX <br /> CCMPL_=nCN <br /> SPECIAL PERMIT INFO. Ground Surfacs <br /> Distance to sewer line <br /> grout <br /> Domestic well on site - (y/ n ) - ft. <br /> o. If yes, location and distance - <br /> V5 <br /> SAMPLING — C <br /> 0 <br /> � �lora.�f <br /> c/J aocicn <br /> cz Holding Temperature Y <br /> Method ' <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) } <br /> tt. —' tt. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - / n ) 7"G� 1'n �I <br /> Storage Location 1.'�DDb TGE Casing type U 1. <br /> Blank_ ft. Screen /L) ft. <br /> Slot size X02. <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water_ 2 Bags sand/gravel <br /> Mix Ratios Filter Pack type <br /> /s.ze <br /> Installation Method Surge Block: - 0" 11 ) <br /> Quantity Installed Discussed with ge logy r. - / ). <br /> Type of method41 <br /> EH 29 29 <br />