Laserfiche WebLink
OONITORING WELL INSTALLATION REP00 <br /> Date: 42O? CONSTRUCTION <br /> Premise Address: "7W 3D9 0-0'2-. Total Depth 110 <br /> k Screen Length (from) NO (to) /07-5 <br /> Well No.: � Pt Filter Pack (from) I t u (to) (O S <br /> • Bentonite (from) 105 (to)�O <br /> Inspector: Grout (from <br /> Drilling rig type — <br /> Permi o. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company': <br /> Driller:�� /� - V'�^ F " `T casing <br /> height <br /> Consultan <br /> .tu <br /> Geologist - <br /> ABOVE-GROUND <br /> CONFLETION CHA S7Y BOX <br /> .LETT <br /> SPECIAL PERMIT INFO. Ground SiCB <br /> �D <br /> RE <br /> grout <br /> Distance to sewer line r <br /> Domestic well on site - (y(� /°o n. <br /> If yes, location and distance - /oZ� 6v 5 n. <br /> — m <br /> — o <br /> SAMPLING dotted _ 8 <br /> sac5on <br /> Holding Temp re G I gmP <br /> Method <br /> Screening Method Z <br /> Tracking Sheet -0n ) <br /> SPOILS <br /> Storage Method Mik f Un aQ a/� v\5 Q MATERIALS DEVELOPMENT <br /> Contamination Noted - y n ) <br /> Storage Location_/M � Casing type �, <br /> Blank /,7-5 ft. Screen 2 z rt. <br /> Slot size — <br /> GROUTING Bags cement <br /> / Buckets bentonite NDN <br /> Depth to water z Bags sand/gravel Z '2- <br /> Mix <br /> Mix Ratios '' 3o Filter Pack a/size <br /> Installation Method - ti" Surge oc c - (yn <br /> Quantity Installed 2Z54 /' fiPnwG Discussed with geo st: - (y/ n) <br /> P✓°L Type of method <br /> EH 29 29 <br /> (A167 ee K C J <br />