Laserfiche WebLink
JNITORING WELL INSTAU AMON REPO <br /> i <br /> 11 i <br /> Date: 10 12-,9-2- CONSTRUCTION <br /> � Total Depth_ y-1 r 33.5 1 i <br /> Premise Address: 1, -- <br /> R Screen Length (from) 33 (to) <br /> Well No.: - y Filter Pack (from) 3-3-:5 <br /> Bentonite ' (from) 9 (to) <br /> Inspector: Grout (from) _ -(to) <br /> Drilling rig type Crr+e _ - <br /> Permit No.. 0i2- 34�)- Auger O.D. I.D. 2� <br /> Completion - Stove pipe/cluistie box (circle one) <br /> Drilling Company: <br /> Driller: Qt G casing <br /> height <br /> Consultant <br /> fIT <br /> Geologist <br /> ABOVE-GACUND *1S*rr-aax <br /> col��r>ara con*n.En0N <br /> SPECIAL PERMIT INFO. G=rid Surta�a <br /> Distance to sewer line <br /> Domestic well on site - {y �. ,ft. <br /> If yes, location and distance - <br /> a <br /> SAMPLING slorad i G <br /> s41_�cn <br /> Holding Temperature r <br /> lack <br /> Method C� <br /> Screening Method ► ' <br /> Tracking Sheet / n ) <br /> ft. ir — tt. <br /> SPOILS <br /> Storage Method ON JOEL e__ MATERIALS/DEVELOPMENT <br /> Contamination Noted . {y/ n ) IF= <br /> Storage Location Ong Casing type qtr 5c1,� ] Rlc_ <br /> BIank 1 o ft. Screen 23 ft. <br /> Slot size O <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 /> Quantiry Installed Discussed with geologist. - (y/ n> IJA <br /> Type of method <br /> EH 29 29 <br />