Laserfiche WebLink
ONITORING WELL INSTALLATION REPOne <br /> /' 3 ,vy� <br /> ci s- Nay 33 <br /> Date: I �C� �` CONSTRUCTION <br /> —Aefo33 35 <br /> Premise Address: /i�W Du'k* Arvej Total Depth fy 5 <br /> Screen Length (from) 32W,,O (to) <br /> Well No.: M LJ X06 Filter Pack (from) (to) <br /> NG� Bentonite (from) (to) <br /> Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> V� Completion- Stove pipe/christie box (circle one) <br /> Drilling <br /> Company: - <br /> tv�h casing <br /> Driller: / height <br /> Consultant Tr <br /> Geologist <br /> T <br /> Geologist 260Y �rc CY ABOVE-GROUND CNAu'iY4= <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. �� �Surtan + <br /> grout <br /> Distance to sewer line <br /> Domestic well on site - (y/ n) n• <br /> If yes, location and distance - n• <br /> n. <br /> _ o <br /> = m <br /> — o <br /> SAMPLING slotrod S <br /> wc5on <br /> Holding Temperature <br /> Metho R, = <br /> Screening Method <br /> Tracking Sheet - (y/ n) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT �o <br /> Contamination Noted - (y/ n ) Casing type 11C Z <br /> Storage Location Blank ft. Screen ' h <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite '/y-7a °D <br /> Depth to water Bags sand/gravel <br /> s Filter Pack type/size <br /> Mix Ratio <br /> ISurge Block: - (y/ n <br /> Installation Method ) <br /> Quantity Installed Discussed with geologist: - (y/n) <br /> Type of method <br /> EH 29 29 <br />