Laserfiche WebLink
M�TORING WELL INSTALLATION REPORT <br /> Date: i l Z CONSTRUCTION <br /> Premise Addres Total Depth <br /> Screen Length (from)�Z � <br /> Well No.: Filter Pack (from) L 7i2 (toOD <br /> ) <br /> Q Bentonite (from) (to) <br /> Inspector. �vb`� �- Grout (from) (to) <br /> ��� " Drilling rig type <br /> Permit No.- 31& Z Auger O.D. I.D. <br /> Drilling Company: Lt"KJ�-C�/�/ <br /> ` Completion - Stove pipe/christie box (circle one) <br /> Driller: casing <br /> Consultant vA/l( .C.f17® rn height <br /> Geologist T <br /> ABOVE-GROUND <br /> COMPLETION CHAIM-Sox <br /> SPECIAL PERMIT INFO. GroundCOMPL-=nCN g�{xy <br /> Distance to sewer line Ori <br /> Domestic well on site - (y/ n ) ft. <br /> If yes, location and distance - <br /> ft. <br /> ft. <br /> p� a <br /> — m <br /> ws+ <br /> SAMPLING sloned 'M <br /> sacicn <br /> Holding Temperature <br /> Method ' = yT 91 F <br /> Screening Method = <br /> Tracking Sheet - ( y/ n ) _ <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) <br /> Storage Location Casing type <br /> BlankScreen 2 ft <br /> Slot size e T / <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravelOaks i <br /> Mix Ratios Filter Pack typesize <br /> Installation Method Surge Block: - (y/n ) <br /> Quantity Installed Discussed with geologist: - (y/ n) <br /> EH 29 29 Type of method <br />