Laserfiche WebLink
MONITORING WELL INSTALLATION REI*r <br /> Date:�23/d,� <br /> CONSTRUCTION <br /> Premise Address: 1Z5-'01 / 11( lQ„-1 LOA '" 3� ift' Total Depth <br /> Well No.: Screen Length (from) (to) <br /> Filter Pack (from) (to)— <br /> Inspector: Bentonite (from) (to) <br /> Grout (from) (to)� <br /> Permit No. Drilling rig type <br /> ,,gy�pp Auger O.D. I.D. <br /> Drilling,Company: Completion- Stove pipe/christie box (cir— c]�— <br /> Driller: <br /> —�^ casing <br /> Consultant--k k-' T height <br /> Geologist_ Alt'j L� <br /> ABOVE-GACUND <br /> COWLETION CHRI.5N-BOX <br /> SPECIAL PERMIT INFO. GCOMPLETION <br /> �nund SuAxe <br /> Distance to sewer line <br /> Domestic well on site - (y/n ) n 1 <br /> If yes, location and distance - Ja AO �L/ 1 ft <br /> — m <br /> — o <br /> SAMPLING = c <br /> aioited — c <br /> Holding Temperature <br /> Method _ Lie V p-g tQ0M4i - frayslpads <br /> Screening Method = <br /> Tracking Sheet - (y/n) <; <br /> SPOILS <br /> Storage Method <br /> Noted - MATERIALS/DEVELOPMENT <br /> Contamination <br /> CY/n) <br /> Storage Location Casing type InPJy <br /> Blank ft. Screen g, <br /> GROUTING Slot size 000 <br /> Bags cement <br /> Depth to water Buckets bentonite <br /> Mix Ratios Bags sand/gravel_ N q <br /> Installation Method Filter Pack type/size <br /> Quantity Installed Surge Block: - (y/ ) <br /> Discussed with geologist: n ) <br /> EH 29 29 Type of method_g� w� a pCs <br />