Laserfiche WebLink
MONITORING WELL INSTALLATION REP•' <br /> Date: Lo®3 2a-, CONSTRUCTION <br /> 7-- 2 <br /> 12 <br /> Premise Address: � < Total Depth 15 / <br /> Well No.: A51 Screen Length (from) 55 (to) L <br /> Filter Pack (from)—�Dto) �1 <br /> Inspector: t —c� Bentonite (from) (to)�— <br /> Grout (from (to) <br /> L 43 Drilling rig type <br /> ' <br /> Permit No. �`�/ <br /> Auger O.D. I.D. <br /> Drilling pany: <br /> �� Completion - Stove pipe/christie box (circle one) <br /> Com/� � �� <br /> Driller: a. � > <br /> casing <br /> �� height <br /> Consultant <br /> Geologist � _ T <br /> ABOVE-GROUND <br /> OOWLETION QHR STY 80 <br /> SPECIAL PERMIT INFO. SurfaceN <br /> Distance to sewer line groat <br /> Domestic well on site - (y tI <br /> If yes, location and distance - T R ft. <br /> 5 t ft. <br /> _ a <br /> = m <br /> = m <br /> SAMPLING = ` <br /> 0 <br /> sac9on H 2 <br /> Holding Temperature <br /> Method vivo'pade <br /> Screening Method A = <br /> Tracking Sheet - n ) <br /> 55 ft = n. <br /> SPOILS / d 57Li <br /> Storage Method 5'.5A � (a—ksc" p MATERIALS/DEVELOPMENT <br /> Contamination Note - n ) �+ // • / <br /> Storage Location Casing typec_ �l t c"k -to `/�V C <br /> Blank `3L ft. Screen---5 ft. <br /> Slot size OZO <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to waterBags sand/gravel 2 2 <br /> Mix Ratios Filter Pack type/size 2,417, <br /> Installation Method Surge Block: - (y n <br /> Quantity Installed Discussed with geologist: - (y <br /> EH 29 29 Type of method <br />