Laserfiche WebLink
`MONITORING WELL INSTALLATION REP . " <br /> `I Date: <br /> 7 CONSTRUCnON_ <br /> Premise Address:_, �7 ;W� QJr� Total Depth IT- 7M x I <br /> y Screen Length (from) 5 (to) <br /> Well No.: Vrt�_ VV _J�_ I Filter Pack (from) (to) <br /> Bentonite (from) <br /> ' Inspector: ' Grout (from)__ S (to) 0 <br /> 6 ' m - Drilling rig type <br /> Permit No.--.-.. ( `-f' Auger O.D. <br /> -� - <br /> Completion Stove pipe/ iristie box circle one) <br /> Drilling Company: <br /> i <br /> V- --- <br /> Driller: casingT <br /> height k: 1 <br /> Consultant 17M TVM _ <br /> Geologist <br /> .ABOVE-GROUND GiR1STY-80X <br /> 00l�tETiOM CQMPLETZON 4 <br /> SPECIAL PERMIT INFO. - � C3rouM Swixs <br /> Distanc o sewer line - grout .. <br /> Domestic w on site - ( n) . <br /> If yes, location di ce - l <br /> SAMPLING <br /> '# socIon <br /> Holding Temperature <br /> Method <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) <br /> ? F <br /> `1 SPOILS <br /> Storage Method ., -MATERIALS/DEVELOPMENT <br /> Contamination Noted - /n2 <br /> " t <br /> Storage Location _ Casingtype <br /> Blank ft. Screen ft. <br /> ` Slot size Y c� <br /> GROUTING Bags cement <br /> N .. Buckets bentonite t. <br /> Depth to water f C� Bags sand/gravel <br /> 3' Mix Ratios ;, Filter Pack type/size o' c4( <br /> Installation Method Surge BIock: - (y/ n Gyp �cJ u4[Il�f6� <br /> Quantity Installed t N. Discussed with geologist: - y/ n) <br /> ? Type of method <br /> F.H 29 29 <br /> 5 <br /> i <br />