Laserfiche WebLink
a <br /> `-40NITORING WELL INSTALLATION REPC`�"'��' <br /> Date:.. 10 ,. �:.. CONSTRUCTION T1� ( t 6c,i <br /> Premise Address: VL V)r A NW Nn l _ Total Depth <br /> - a Screen Length (from) (to) SD I <br /> Well No.: AOS-13 Filter Pack (from) ` (to)�T <br /> Bentonite 1 (from)_ + 5' <br /> Inspector- Grout_ �}` Grout -' (from) (to) 3 <br /> _ Drilling rig type E <br /> Permit No. L (2 _ Auger O.D._'9,,Y. <br /> - Completion - Stove pipe/ stie b , {circle one) <br /> Drilling Company-. _ <br /> Driller. VO�+�,; �w� '.)OAoo►/Q� y _ casing <br /> •.. ... ..� -. ,. w ..... � � height <br /> Consultant <br /> Geologist.p � L6bu ti .' ' <br /> - A801 -r.oROl1ND CHRzrY-BOX <br /> COWPLE CN COMPLZnON <br /> SPECIAL PERMIT INFO. - G=rd Sufacs <br /> 4�� E <br /> Distance to sewer line <br /> Domestic well on site - (y/ n ) `� 3' it. <br /> If yes, location and distance - - a tL <br /> d <br /> 040 <br /> SAMPLING w_v . 1 <br /> section : — <br /> Holding Temperature gmvei pack <br /> Method <br /> Screening Method - - ' — <br /> Tracking Sheet n) : — <br /> _ �tt. :� — O ft. <br /> SPOILS <br /> Storage Method - MATERIALS/DEN LOPMENT <br /> Contamination Noted - ( / n ) %N <br /> Storage Location „ r Casing type- . V G z <br /> k 0�^'�� St 5 . (/�i �.� [�•r Blank H�,5' ft. Screen ft. <br /> Slot size co'L <br /> GROUTING Bags cement a <br /> 4 _ Buckets bentonite <br /> Depth to water ti S_{ y Bags sand/gravel <br /> l Mix Ratios Filter Pack type/size 41, <br /> Sure Block: - {y/0 <br /> installation Method g <br /> Quantity Installed - - Discussed with geologist: (y/ n ) y <br /> Ir"el I 1Q I'd ccvo Type of method <br /> EH 29 29 r <br /> ' �M.l�-�7It C71 :w�M!yC/�. to �[�Ci►v� `"�"�' .�,SO CCAVkV -1 - <br />