Laserfiche WebLink
i l <br /> '*0'MONITOAING WELL INSI'Al..iATION <br /> Date: ( <br /> CONSTRUCTION "'d-4 S3-?Z <br /> -41Sa5 �1�� Total Depth 251-60 <br /> ?remise Address:_ Screen Length (gym) ZS' (to) S <br /> So 12 Filter Pack (from} (to)� � <br /> Well No.: _ Bentonite {froze) (to} 3 <br /> JGrout (from) (to) sur <br /> Inspector. Drilling rig type K <br /> Permit No. Auger O.D. <br /> Completion - Stove Qipe/christie box (circle one) <br /> Drilling Company: <br /> Driller-. d' �` f height !4 <br /> Consultant r ,TC <br /> SSO <br /> A <br /> Geologist twy;��p��p <br /> tCtwlPL* fON giFtC.S'iYX <br /> COmPt.-ncN <br /> SPECIAL PERMIT INFO. - - r aacsrd 5urfacs <br /> 70A <br /> Distance to sewer line <br /> Domestic well on site - ( y/ n } 3 `�- <br /> If yes, location and distance - LOCU —: K• <br /> jwo <br /> SAMPLING Y1�lQSL] sto[zr�d <br /> Holding Temperature71 Packif1Q�-� IS <br /> Method <br /> Screening Method._ <br /> Tracking Sheet - ( n) �!, , ) Z <br /> "`/ ' n _.... n <br /> SPOILS `s <br /> dn*w, � <br /> Storage Method MATERIALS EVELOPMENT <br /> Contamination Noted - y n) V <br /> Storage Location SI Casing type <br /> Blank_ .� f Oz Screen 2A f[ <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water ! ^� Sags sand/gravel <br /> Mix Ratios Filter Pack typeVops <br /> Installation Method t'Q (�� Surge Block: - ( <br /> Quantity Installed Discussed with g - / n} <br /> Type of method a t <br /> EH 29 29 <br />