Laserfiche WebLink
�ICONITORING WELL INSTALLAIiION REPOn'Y <br /> Date: CONSTRUCTION <br /> Premise Address: Total Depth Z�P <br /> Screen Length (from) ZA:5 (to) 13-5 <br /> Well No.: Filter Pack (from) 25 (to) <br /> Bentonite (from) La (to) <br /> Inspector: Grout (from) (to) O <br /> Drilling rig type <br /> Permit No. 5 Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: �fi <br /> Driller: f a casi <br /> Consultant CA(2 � <br /> i heigh <br /> Geologist _)' c- <br /> ABOVE-GAOUND ONAIS'TY$OX <br /> COMP COMPLETION <br /> SPECIAL PERMIT INFO. Ground SWxs <br /> Distance to sewer line grout <br /> Domestic well on site - (y) n ) 2 1 y tt <br /> If yes, location and distance - <br /> Ott. <br /> _ F � tt. <br /> = m <br /> _ tl <br /> SAMPLING dotted = y. <br /> vection — - <br /> Holding Temperature = gRYq Pack <br /> Method = <br /> Screening Method <br /> Tracking Sheet - (y/ n ) 2 n 5 <br /> Z tt. tt. <br /> SPOILS <br /> Storage Method LJt�t MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) �Jn /n <br /> Storage Location Casing type '7 / l�C <br /> Blank LA•S ft. Screen t_Oft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water S Bags sand/gravel <br /> Mix Ratios "O' Filter Pack type/size � <br /> Installation Metriod Surge Block: - (y/ n ) <br /> Quantity Installed 3' z &4K A.;:,c (= 56izN(=56Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 q <br /> /- X00- <br />