Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date:_ t� 11 CONSTRUCTION <br /> Premise Address: Total Depth 6U <br /> Well No.:. Screen Length (from)_!;' <br /> Filter Pack (from) (to)�_ <br /> Bentonite (from) S (to) C 3 <br /> Inspector: IJ In w ►h Grout (from) '(to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: ('.G.,c^k <br /> Completion - Stove pipe/christie box�(circle one) <br /> Driller:_ Toy✓ S casing <br /> .GT lA +r height <br /> Consultant �Y' ,� <br /> Geologist <br /> ABOVE-GROUND <br /> CON-PLE-WN CHAISry-80X <br /> SPECIAL PERMIT INFO COMPLETION <br /> Ground Surlacs <br /> Distance to sewer line grout <br /> Domestic well on site - n ) 1 <br /> If yes, location and ' tance - _♦ h, <br /> Y <br /> m <br /> SAMPLING = <br /> _ o <br /> clotted c <br /> — <br /> Holding Temperature axdon — <br /> Method = gnLe1 padt <br /> Screening Method — <br /> Tracking Sheet - (y/ n ) <br /> (00 <br /> d tt. <br /> SPOILS <br /> Storage Method ��. /„ 7 MATERIALS/DEVELOPMENT <br /> Contamination Noted - <br /> Storage Location Casing type 7 �M <br /> Bland ,%', ft. Screen h <br /> Slot size .b Lo <br /> GROUTING Bags cement ti t C> <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel_i✓3 <br /> Mix Ratios q ei ((�.^� �/ Filter Pack type/sizes�� (C <br /> Installation Method %� .��. Surge Block: - (y/� <br /> Quantity Installed Icy c� n ur(�(o� Discussed with geologist: - ( y/0) <br /> EH 29 29 Type of method <br />