Laserfiche WebLink
OIdITORING WELL IN5CAL1 AT[ON pEr :T <br /> CONS N <br /> Date: <br /> Total Depth <br /> Premise Address: Screen Length (from) (to) <br /> Filter Pack (from)-�([o) <br /> Well No., Bentonite (fTOTR) _(to) <br /> Grout (from) <br /> Inspector. Drilling rig type <br /> Auger O.D,� <br /> Permit No. Completion - Stove pipe/christie box (circle one) <br /> Drilling Company <br /> casino <br /> height <br /> Driller: . _ <br /> Consultant <br /> A?gVE-GRCUND SSM-aox <br /> Geologist COMPLETION O,i?l_-S1oN <br /> �� Gcpurxf Suiaca <br /> SPECIAL PERMIT INFO. prat <br /> Distance to sewer line _ <br /> Domestic well on site .- (Y/n) <br /> If yes, location and distance - r. <br /> I vh = o <br /> 0 <br /> 0 <br /> c <br /> ttoC.ad �. �p <br /> SAmpUN G socicn <br /> Staval Pack <br /> Holding Temperature <br /> Method <br /> Screening Method <br /> Tracking Sheet - (Y/ n) <br /> SPOILS MATE ALS/DEVEI,OPMENT <br /> Storage Method Casing type ft. <br /> Contamination Screen -- <br /> Storage Location Blanker—fr <br /> Slot size <br /> Bags cement <br /> GR_oUTING <br /> Buckets bentonite <br /> Bags <br /> sand/gravcl <br /> Depth to water Filter Pack type/size <br /> Mist Ratios Surge Block: - (Y/n) <br /> installation Method Discussed vrith geologist: - (Y/ n) <br /> Quantity Installed Type of Method <br /> EH 29 29 <br />