Laserfiche WebLink
_dONITORING WELL INSTALLATION REPO. s <br /> Date: CONSTRUCTION <br /> Premise Address: 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 /> Drilling Company: Completion - Stove pipe/christie box (circle one) <br /> Driller: casing <br /> height <br /> Consultant <br /> —ZF <br /> Geologist T <br /> ABCVE-GROUND <br /> COMPLETION Ct(Fi1STY-80X <br /> SPECIAL PERMIT INFO. COMPLEnCN <br /> C3round Sufact <br /> Distance to sewer line V1,1, grout <br /> Domestic well on site - ( y/ n ) l <br /> If yes, location and distance - _L._,ft. <br /> ft. <br /> SAMPLING — o <br /> sloned <br /> Holding Temperature <br /> Method pawl Pack <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) _ <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 t water �6 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 /> EH 29 29 Type of method <br />