Laserfiche WebLink
'U' ONITORING WELL INSTALLATION REP ' a <br /> .Y <br /> . i ,. C�nxrvFc I <br /> 5 �2 <br /> I\\tea C <br /> Date:9 CONSTRUCTION <br /> Premise Address: "! 2VJ Total Depth � 1 <br /> A n Screen Length (from) O (to) �o <br /> Well No.: M V�/ Filter Pack (from) 6 (to) <br /> ^ n Bentonite (from) (to) 4� <br /> Inspector. I`�l I `e�1Ts Grout (from) (to) 0 <br /> Drilling rig type !O <br /> Permit No. Auger O.D. I.D. ! <br /> (� Compledo - cove pi ch istie box (circle one) <br /> Drilling Company: r C EX1710 ra-h Orl <br /> ]bn 5enk ns Bruce W nr) <br /> Driller: DrlilevNet V casing <br /> \ ' <br /> Consultant_ Y V �T height <br /> Geologist b�Ve 'Three - <br /> ABOVE-GRCUND CHRlM-BOX <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO: Ground SuAaC <br /> Distance to sewer line ! grout <br /> Domestic well on site - (y/ n) <br /> 1f yes, location and distance - <br /> ]v ft ft <br /> SAMPLING dotted = ` <br /> socicn —' <br /> HoldingTemperatt�ut��ei = g"VW <br /> Method (YUA/Lf,lf1 <br /> Screening Method ?L 12 <br /> Tracking Sheet - (y/ ti ) __ <br /> _ ft. <br /> SPOILS <br /> Storage Method !a MATERIALS/DEVELOPMENT <br /> Contamination Noted - n) <br /> Storage Location /ydo Casing type 4 1') 4 D <br /> u Blank 60 _ft. Screen <br /> Slot size <br /> GROUTING �.� Bags cement <br /> n�^ 'ry Buckets bentonite <br /> Depth to water / `� '(� i / Bags sand/gravel <br /> Mix Ratios Filter Pack type/size d /Z <br /> Installation Method Surge Block: - (y n <br /> Quantity Installed Discussed with geologist: - n) <br /> Type of method <br /> EH 29 29 - d <br /> p <br />