Laserfiche WebLink
1GE jJ_OFJ3 <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: /� ! I II CONSTRUCTION <br /> Premise Addr asa Well No. <br /> Inspectors � y Total Depth <br /> LL++ Screen Length -60 <br /> Filter Pack <br /> GG11 Bentonite Pellets <br /> Permit No. Grout <br /> Consultant Completion-Stow . pip Christie box <br /> Geologist t <br /> Auger O.D. <br /> Auger I.D. <br /> SAMPLING --- — <br /> Holding �T, e�I/Jap� @Lrature afkk-up <br /> Method YYK lr SfDy - <br /> Screening Method f Vf <br /> ABOVE-GROUND CHRISTY-BOX <br /> Tracking Sheet (y10 COMPLETION COMPLETION <br /> ��.�Citourd Suriaorr <br /> SPOILS <br /> Orad <br /> Storage Method A <br /> Contamination Nbted - yes o <br /> Storage Lo ation ft16 . <br /> tg i� -3 Map— tow ? n. <br /> _ <br /> _ <br /> SPECIAL PERMIT INFO. _ <br /> 0 <br /> Boned = B <br /> Distance to sewer line ->5W saclon ply Domestic well on site yes no <br /> If yes, ocaton & distance - <br /> GROUTING <br /> MATERIALS USED: <br /> /L II <br /> Depth to water � IST Casing type Pur :1 <br /> Mix Ratios 4-W14 Ily Blank_'D _ ft. Screen Va ft. <br /> Installation Methodti 0.✓ILli�l-42. Slot size •Oy <br /> Quantity Installed Bags cement <br /> cj jyjSpQ Buckets bentonite sa pWuwt <br /> UU Bags /gravel n�„-- <br /> 7Filter Pack type/sizet�,w}2 <br /> Total Billed Time Per Site <br /> Date Permit Finalized <br />