Laserfiche WebLink
MONITORING WELL INSTALLATION 1, JRT <br /> Date: CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from)' (to) <br /> Well No.: Filtet Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: Completion- Stove pipe/christie box (circle one) <br /> Driller: <br /> TT casing <br /> height <br /> Consultant , <br /> Geologist <br /> AZO VE-GROUND <br /> a-)F'LETc N C}W 1S'TY-BO X <br /> SPECIAL PERMIT INFO. COMPLETION <br /> C3rourj 5:alaca <br /> Distance to sewer line oro <br /> Do nestic well on site <br /> ut <br /> If yes, location and distance - h, <br /> ft. ft. <br /> — m - <br /> SAMPLING = � ----- ------ ---- <br /> 0 <br /> " ►•aeon - — � <br /> Holding Temperature <br /> Method = pre vs(Pacts <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 (.y—Ln—) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> EH 29 29 Type of method <br />