Laserfiche WebLink
PnwPE Z OF 3 . <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: CONSTRUCTION <br /> Premise Address:,/05"O S. !✓.t�•.OonO Well No. <br /> Inspector• i' Total Depth <br /> f� - Screen LcrseJth <br /> Filter Pack 1• <br /> Bentonite Pellets h1.9) <br /> Permit No. h0 - 33 /`j Grout 1 o a 4 ow,u"- <br /> t-Consultant G✓—e7�Tss / sem_ Completion-stove pip christie ox <br /> Geologist <br /> Auger O.D. 70 c <br /> Auger I.D. <br /> SAMPLING <br /> s&k- p <br /> Holding Temperature <br /> Method ;EQon <br /> Screening Method <br /> ABOVE-GROUND CHRISLY-BOX <br /> Tracking Sh t (y9 COMPLETION COMPLETION <br /> 250 9POILS <br /> Ground sur'"° <br /> OILS <br /> proal <br /> Storage Method <br /> n. <br /> Contamination Noted - e no n. <br /> Storage ocation <br /> ®ir s <br /> LiJOc✓ s✓C//� /n�tC f G'i/G�ySrS <br /> a <br /> m <br /> SPECIAL PERMIT INFO. <br /> _ o <br /> sloped _ 8 <br /> Distance to sewer line section <br /> Domestic well on site -�s/no _ D <br /> If yes, location & distance - _ <br /> GROUTING <br /> MATERIALS USED: <br /> Depth to Ovate <br /> 71 Casing type 'PyC- C/ <br /> Mix Ratios Blank ft. Screen �� ft. <br /> Installation Metho Slot size •d Z <br /> Quantity installed y� Bags cement <br /> ^^ Buckets bentonite <br /> � I�M Bags sand/gravel <br /> Filter Pack type/size <br /> Total Billed Time Per Site <br /> Date Permit Finalized e4 ,/ r-�/SC . <br />