Laserfiche WebLink
MONITORING WELL INSTALLAnON REPORT <br /> Date: c 1 <br /> CON SI RUCTION <br /> Premise Address: <br /> Total Depth <br /> Well INIO.: N Screen LengLh (from)_. ;s ` _(to) <br /> Filter Pack (from) <br /> Inspector. Bentonite (from) <br /> Grout (from) °) <br /> Dermic No. Drilling rig type <br /> Auger O_D. L.D. <br /> Drilling Company: Camplctson - Stove pipe/cJlristie box <br /> (circle one) <br /> Drill er; <br /> casing <br /> Consultanc he-ight <br /> Geologist <br /> SPECIAL PERMIT INFO, C0Ch- t_.FT1CIY GFi tel'ocx <br /> CO .mCN <br /> D;sra.nce to sewer line <br /> Domestic well on site <br /> If Yes, 1OcaC0n and dis��ce - <br /> SA_ LjtiTG <br /> — Y <br /> HL-I&nTem 'rorpi = c <br /> * ,� pera[ure <br /> Screen n,7 Method CnY� <br /> 4 =� <br /> Tracking Shcet - ( y/ n ) 4- <br /> .r <br /> S?01I.S <br /> �t. <br /> Storage Me�►:od {n,�,yC� <br /> CC.,tarninat;on Noted - MATE1tLALS EVEI.OPMEN T <br /> Storage Location / n ) �' ) (d <br /> Casing type <br /> Blank iG Screen <br /> CR�_CII Slot size <br /> G <br /> Dept- to water rv}U ` Bags cement <br /> Buckets bentonite <br /> I`;iY Ratios Bzgs sandJgravel <br /> instaJia o"I Method Filter Pack type/size <br /> Qaa.tiry lnst2IIed Surge BIock: - (y---------------- <br /> Discussed with geologist: - ( y <br /> PH 29 29 Type of Method <br />