Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date:_ CONSTRUCTION <br /> Premise Address: 3�SJ G Well <br /> I FiWL <br /> Inspector: Total Depth '� <br /> Screen Length-47 <br /> Filter Pack - 24 - -: <br /> y Bentonite Pellets --7 -JO -6R <br /> „S <br /> Permit No. l�J '' Ul 'f- Grout ' 7 <br /> Consultant_ CSAIU.4_-/&-r_ 9" Completion-Stove pip • christie box' - <br /> Geologist V71400 <br /> Auger O.D. .2 <br /> Auger I.D. 2 <br /> SAMPLING <br /> Holding Tem era re <br /> Method TT <br /> Screening Method <br /> Tracking sheet Oh) wovesNouno <br /> ConwLETaN Cn Isn-box <br /> SPOLLSCOMPLETION <br /> o�wnd snr.�� <br /> w� <br /> Storage Method &Ymel /G <br /> Contamination Noted - yea/no —n' <br /> Storage Location —n• <br /> n. <br /> = <br /> SPECIAL PERMIT INFO. .loud anion _ <br /> 1 = p..rpaa <br /> Distance to sewer line <br /> Domestic well on site - yea/ o <br /> If yes, location & distance <br /> GROUTING - MATERIALS USED: <br /> Depth to water Casing tpe <br /> v Mix Ratios Blank y ft. Screena77 _ft. <br /> Installation Method Slot size D•�'l2v <br /> Quantity Installed Bags cement <br /> Buckets bentonite . () <br /> Bags sand/gravel <br /> Filter Pack type/size �� <br />