Laserfiche WebLink
(i <br /> M MONITORING WELL INSTALLATION REPORT <br /> p <br /> i <br /> f <br /> Date : ` -V3l 0 :1 CONSTRUCTION <br /> Premise Address : l S �kthw1 L ( Total Depth U O <br /> Wel] No. : Screen Length (from) 70 ` (to) Qu ' <br /> Filter Pack (from) 1 x ` (to) L1v ' <br /> Bentonite (from) it (to) t <br /> Inspector: rrpinPyli crtrre.�Yl t Grout (from) (to) 11, <br /> Drilling rig type <br /> Permit No. :EC( Ia V o A, $ g Auger O.D. I .D. <br /> Drilling Company: CUhLw � ✓C <br /> Completion - Stove pipe/christie box (circle one) <br /> Driller: casing <br /> p height <br /> Consultant -�• <br /> Geologist - (/L lo C&r T <br /> ASCVE-GFICUND <br /> COMPLETION CHRIMT BOX <br /> COMPLETION <br /> SPECIAL PERMIT INFO, Ground Sauce <br /> Distance to sewer line grout <br /> Domestic well on site - ( y / n ) <br /> If yes, location and distance - I ( n <br /> To <br /> . d <br /> SAMPLING Betted <br /> sac5on <br /> Holding Temperature <br /> Method = grave, Pad( <br /> Screening Method _ <br /> Tracking Sheet - ( y / n ) <br /> AL7 n. n. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y / n ) <br /> Storage Location Casing type_ Dur_ St lti 4 � <br /> Blank fr. Screen ft. <br /> Slot size r➢_ o - <br /> GROUTING Bags cement a_&gV:c. <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel lS . � <br /> Mix Ratios (1? — e u(rc Filter Pack type/size M � S a y <br /> Installation Method Surge Block: - ( y / n ) <br /> Quantity Installed N � e J2�_ Discussed with geologist: - ( y / n ) <br /> Type of method <br /> EH 29 29 <br />