Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: CONSiRUCnON <br /> b �. J � Total Depth 70 <br /> Premise Address: <br /> Screen Length (from) <br /> Well No.: /MA_%/C Filter Pack (from)=_ (to) <br /> Bentonite (from)__6j__ <br /> from) 6 _(to) e <br /> Inspector. Grout (fro }„ ho (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. 142- <br /> Completion <br /> 4 -Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing' <br /> he; � <br /> Consultant <br /> n <br /> Geologist �. <br /> a,.aovz=-GRcurrn ZMTY.� <br /> CC WL.E'TC N C�MPt_�YICN <br /> SPECIAL PERMIT INFO. <br /> C3+-ourd S+aiaca � <br /> �� procrt <br /> Distance to sewer line <br /> Domestic well on site - ( y 1 n ) G� tt. <br /> if yes, location and distance - 3 ft- <br /> �5 tt. <br /> m <br /> SAMPLING storm <br /> Holding Temperature ' tiT"fW POCK <br /> Method <br /> Screenin;Method <br /> Tracking Sheet - {y/ n } <br /> . '21L-ft. <br /> SPOILS <br /> Storage Method -Vz irl"J 5 <br /> MATERIALS EVELOPME'I T <br /> Contamination Noted - (y/ 1�'��c. <br /> Storage Location- 1� Casing e,I! ft. <br /> Blank �- ft• Screen <br /> Slot size 0•d L6 <br /> GROUTING Hags cement <br /> ( Buckets bentonite <br /> Depth to water S Bags sand/gravci <br /> Mix Ratiosrw t �'G Filter Pack type/ *ze <br /> Installation Method Surge Block: 0 <br /> Quantity Installed Discussed with cologist: - I n ) <br /> Type of ractliod <br /> EH 29 29 <br />