Laserfiche WebLink
` MONITORING WELL INSTALLATION REPCnr. <br /> Date: CONSTRUCTION <br /> Premise Address: O'3L Total Depth <br /> Screen Length (from) (to) <br /> Well No.: �� Filter Pack (from) (to) <br /> Bentonite (from) (to) _ <br /> Inspector: Grout (from) (to) <br /> Drilling rig type l <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: St— casing <br /> height <br /> Consultant <br /> Geologist •� <br /> ABOVE-GROUND <br /> COMPLETION CNRJSTY-BOX <br /> Pt.ET <br /> SPECIAL PERMIT INFO. Ground SLxrfxa <br /> Distance to sewer line grout / <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - ft' <br /> 3b it. <br /> _ p <br /> SAMPLING slotted <br /> soon :t <br /> Holding TemperatureV'W Pack_ <br /> Method = <br /> Screening Method <br /> Tracking Sheet ( y/ n ) <br /> _L=ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y/ n ) 'q*j <br /> Storage Location Casing type <br /> Blank ft. Screen <br /> Slot size b(c) " _ <br /> GROUTING Bags cement -I'7 <br /> Buckets bentonite <br /> Depth to water '-'% Bags sand/gravel <br /> Mix Ratios Filter Pack type/siz a <br /> Installation Method Surge Block: (y n ) <br /> Quantity Installed Discussed with ge st: ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />