Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: qO CONSTRUCTION <br /> Premise Address `�3d 5 �` � Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack ^ (from) (to) <br /> Beritoriite '(from) (to)_ <br /> Inspector: Grout (from) (to)__ <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion- Stove pipe/christie box (circle one) <br /> .Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist <br /> ABOVE-GROUND <br /> COMPLETION CHRtM43OX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground gur{a" <br /> Distance to sewer line Grp <br /> Domestic well on site - (y/n ) <br /> If yes, location and distance - <br /> . ft. <br /> ft. " <br /> �F p <br /> SAMPLING — s <br /> Slotted <br /> saclon <br /> Holding Temperature < _ <br /> Method = _ graw Pack <br /> Screening Method <br /> Tracking Sheet - (y/n) ` <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - (y/n) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />