Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> far►, <br /> Date: I - f 5 I CONSTRUCTION <br /> Premise Address: 35 b� I �'�-�� �^^� C Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (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 /> �► <br /> he; <br /> Consultant -t T7c,/ - IV <br /> _qGeologist T <br /> ABCVE-GACUND <br /> COMPL.1_T{ON C}�itSTY-8OX <br /> COMPLETICN <br /> SPECIAL PERMIT INFO. Ground Surfaas <br /> Distance to sewer line <br /> Grout <br /> Domestic well on site - ( y/ n ) ft. <br /> If yes, location and distance - ft. <br /> tt. <br /> SAMPLING ��or.� __ ° <br /> C <br /> :Qcicn — <br /> Holding Temperature < <br /> Method <br /> Screening Method <br /> xq; <br /> Tracking Sheet - ( y/ n ) <br /> _ <br /> ft. <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 />