Laserfiche WebLink
Y 15NITORING WELL INSTALLATION REPORT <br /> Date: � _ CONSTRUCTION <br /> Premise Address: s f-�oc`4-n D Total Depth S y <br /> n,�W � Screen Length (from) (to) 3� <br /> Well No.: /"► Filter Pack (from) S K (to) ?z <br /> Bentonite (from) 3 7 (to) b <br /> Inspector: /� - Grout (from) 3 (to) <br /> ��� ( Drilling rig type !,5 _ <br /> Permit No. Auger O.D. R" I.D. 3 �* " <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: .) <br /> Driller: casing <br /> height <br /> Consultant G-R o 'd <br /> Geologist )MaAA T <br /> ABOVE-GACUND Ci•iRIM-BOX <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surface <br /> Distance to sewer line 7� grout <br /> Domestic well on site - (y n f <br /> If yes, location and distance - ft. <br /> SAMPLING slored <br /> �- secicn .: <br /> 3 <br /> Holding Temp rature < <br /> Method /3,4 6 N_ % 3.c_.e r = f°!Pack <br /> Screenin;Method <br /> Tracking Sheety <br /> ft. <br /> SPOILS <br /> Storage Method - �; cJy� �_ MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y(7 UJ , <br /> Storage Location - Casing type Z 1`f' <br /> Blank 3 V ft. Screen ft. <br /> Slot size .oZy <br /> GROUTING Bags cement <br /> (/ Buckets bentonite <br /> Depth to water r - Bags sand/gravel ohm <br /> Mix Ratios 1111 1 27T77V7 Filter Pack type/size <br /> Installation Method Surge Block: - (y n <br /> Quantity Installed Discussed with geologist: - -0 n) <br /> Type of method <br /> EH 29 29 <br />