Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: r I z s f r <br /> CONSTRUCTION <br /> Premise Addre 6: IND -Ao".'u' - Well No. <br /> Inspector: �__) Total Depth <br /> Screen Length <br /> Filter Pack ' . <br /> Permit No. <br /> I j_G1 I Bentonite Pellets <br /> It( Grout <br /> Consultant Completion-Stove pipe/christie box <br /> Geologist_ <br /> Auger O.D. <br /> Auger I.D. <br /> SAMPLING <br /> Holding Tempera_tur such-up <br /> Methods 1 %-� 7 <br /> Screening Method <br /> ABOVE-GROUND CHRISTY-BOX <br /> Tracking Sheet (yrn) COMPLETION COMPLETION <br /> Ground Surface <br /> SPOILS <br /> Zzl grout <br /> Storage Method <br /> Contamination Noted - ye <br /> Storage Lo/�ation �U �. ft. <br /> — ze <br /> = e <br /> SPECIAL PERMIT INFO. _ ,C <br /> 0 <br /> slotted — C <br /> Distance to sewer line/ section B <br /> Domestic well on site - yes/no <br /> If yes, location & distance - — giPacX <br /> GROUTING <br /> MATERIALS USED: / <br /> Depth to water Casing type 2 P V <br /> Mix Ratios 777 Blank_�(L_ ft. Screen 712 ft. <br /> Installation Method Slot size ©FU <br /> Quantity Installed / Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel oU <br /> Filter Pack type/size .2-1 <br />