Laserfiche WebLink
'%wONITORING WELL INSTALLATION REPO.,, <br /> Date: ( CONSTRUCTION <br /> Premise Address; 14L Total Depth <br /> Screen Length (from)_ (to) <br /> Well No.: l Filter Pack (from) 5 (to) r ' <br /> Inspector. Bentonite (from) 1 (to)—/s <br /> P Grout (from) (to) -6�--- <br /> Drilling rig type <br /> Permit No. Auger O.D. - <br /> Drilling Company; -z� <br /> Completion - Stove pip lu�istiebog ci <br /> crcle one) <br /> Driller- casing <br /> height <br /> Consultant Xr <br /> _Q Geologist �1 N� � �r 1!7 T <br /> AZ;VE-GD C iaS�Y-8CX <br /> GOh�tE!`!ON COMPl.ET1CN <br /> SPECIAL PERMIT INFO. r <br /> pundSwfa= <br /> r <br /> Distance to sewer line 1>5U grout <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance - ft. <br /> SAMPLING <br /> cG sorscn <br /> Holding Temperature "N <br /> Sxav*1 pads <br /> Method ICU -t . <br /> Screening Method f" <br /> Tracking Sheet n ) <br /> SPOILS / <br /> Storage Method _ � Z-/CDU(s V'I'I MATERIALS/DEVELOPMENT <br /> Contamination Noted (y <br /> Storage Location 6N ��t,�rZ Casing typeL— <br /> Blank ft. Screens71 ft. <br /> Slot size D• D/ o <br /> GROUTING Bags cement <br /> j Buckets bentonite Xf, <br /> Depth to water ��a-� L Bags sand/gravel <br /> Mix Ratios '� Filter Pack type/size_ a <br /> Installation Method----/ Surge Block: - W n ) <br /> Quantity Installed Discussed with geologist: - / n ) <br /> Type of method l k-- <br /> EH 29 29 <br />