Laserfiche WebLink
MONITORING WELL INSTALLATION REPOnf <br /> Date: CONS UCTION <br /> Premise Address: Total Depth <br /> Q Screen Length (from) f _(to) <br /> Well No.: Filter Pack (from) 17 (to) <br /> Bentonite (from) /2- 5 (to) <br /> Grout (from) S (to) U <br /> Inspector: <br /> �yDrilling rig type <br /> Permit No. �0 �Z a Auger O.D. $ " I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist AE&E-GROUND <br /> COluPI_ETlON C}¢iLM43OX" <br /> COMPLETION. i <br /> SPECIAL PERMIT INFO. Ground Surface <br /> grout <br /> Distance to sewer line <br /> Domestic well on site - (y n n• i <br /> If yes, location and distance - 12-5 ft- <br /> ft. <br /> G <br /> ' Q l <br /> SAMPLING slotted v <br /> vection <br /> Holding Temperature <br /> l.30 Sd%.L v`• ynvel pack <br /> Method <br /> Screening Method Q 0 <br /> Tracking Sheet y Fn / <br /> Cws WhL.. /�,_tt. <br /> SPOILS - .. <br /> Storage Method aN E U-*A" V'�' MATERIALS EVELOPMENT <br /> Contamiriation Noted - y, n)` '� ti r =y ,2 <br /> Storage Location Wit' of s:� *r y a <br /> Casing type `Y ft. Screen fr• <br /> Bf <br /> -`- w Q O r� `. <br /> Slot size � <br /> -------------- <br /> � ► Bags cement. <br /> GROUTING �,Y n ;fir ; ,, �, +, , "�ti ,> `'Buckets bentonite <br /> 'k u .,�.��,,r r �„. �• Bags sand/gravel <br /> Depth to v+rater Filter Pack type/size <br /> Mix Ratios <br /> Installation Method Surge Block: - (y/ n )-- <br /> `y 'Quantity Installed ; Discussed with geologist: - (y/ n) <br /> Type of method <br /> EH 29 29 <br /> 342A ell - <br />