Laserfiche WebLink
''dONITORING WELL INSTALLATION REPOT 1 <br /> Date: ,!5-, 'a/— 0 CONSTRUCTION <br /> Premise Address: W' Total Depth_ Ob <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) 'f U (to) <br /> / Bentonite (from) (to) 3 <br /> Inspector: Grout (from) (to) O <br /> Drilling rig type <br /> Permit No. �0 6 71-9 Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company �d�ad2 <br /> Driller: I 1' casing <br /> A height <br /> Consultant J7GF <br /> Geologist Ae k r T <br /> ABOVE-GROUND CtiRISTY-BOX <br /> ( <br /> COMPLETION <br /> SPECIAL PERMIT INFO. cab SuAact <br /> Distance to sewer lineSC grout <br /> Domestic well on site - (y/ n ) W ft. <br /> If yes, location and distance - '2aft. <br /> =Lft. <br /> — a <br /> — m <br /> — n <br /> PER <br /> SAMPLING dcttad _ t. <br /> tecdon <br /> Holding Temperature <br /> Method = Gr+�pack <br /> Screening Method <br /> Tracking Sheet - (y/ n ) <br /> SPOILS JO <br /> Storage Method [[ �it�ti MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y ACD Ln V <br /> /, , C <br /> Storage Location Casing type / <br /> Blank. ft. r Screen /0 ft. <br /> Slot size <br /> GROUTING Bags cement 0 f to <br /> Buckets bentonite 'y O <br /> Depth to water 3 Bags sand gravel <br /> Mix Ratios /49/ <br /> 4 ✓ Filter Pack type�/�s-iyze 17, <br /> Installation Method Surge Block: - W n ) <br /> Quantity Installed — + Discussed with geol 'st: - y/ <br /> Type of method y <br /> EH 29 29 // <br />