Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: 9/ CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from)—(to)- <br /> Bentonite <br /> from) (to)Bentonite (from) (to) <br /> Inspector. Grout (from)—(to)- <br /> Drilling <br /> from) (to)Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: Completion - Stove pipe/christie box (circle one) <br /> Driller: JL casing <br /> height <br /> Consultant <br /> Geologist _ T <br /> ABOVEGACl1ND <br /> COMPLETION CHRISTY-Dox <br /> SPECIAL PERMIT INFO, Ground SuAacs COMPLETION <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance - 4 It. <br /> t0R <br /> tt. <br /> vi = <br /> w <br /> SAMPLING o <br /> nomad — 'c <br /> socicn <br /> Holding Temperature = <br /> Method Al <br /> = Vival Pack <br /> Screening Method <br /> Tracking Sheet - (y/ n ) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) y <br /> Storage Location Casing type 7 <br /> Blank L0 ft. Screen 7A h. <br /> Slot size 0.o Z <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size ? <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - / n) <br /> EH 29 29 Type of method l/ <br />