Laserfiche WebLink
- ',.9`ab >+' M :. i e.his-: n.�_ ...» ,r .. •- :,s.P _,y�...r - .... w ..-. "t . _ - <br /> MTORING±WELL INSTALLATION REPOPIJ , <br /> ,. <br /> � Date: CONSTRUCTION <br /> Premise Address: 2 S 5S Jv <br /> 9., Total Depth ' <br /> _ w Screen Length'(from) //. 3 ' (to) S3'' <br /> Well No. VI/- %S Sd"jfra alter Pack (from) 1_G 3` �.(to) /5/ . <br /> i - r!- 6,-07 --Bentonite (from) 1 5"/ (to) <br /> Inspector: V r` Grout (from)_ _ / (to) svr. rL e e <br /> Drilling rig e So n i e-o r e IC <br /> Permit No. d 0 L2 0-27 - Auger O.D. .-JA ekdALIAIC I.D. 7 T/Y" _ <br /> •` , , - - •. -. Completion - Stove pipe/ stie box (circle one) <br /> Drilling Company: �r, �Z e <br /> Driller: _earl �re e e-e, cas inq <br /> Ssra fav J GPo - -�v5'. I height <br /> Consultant L/]1/1 r.b n11 <br /> rc <br /> C <br /> r•erz45` "' �RTJ <br /> -Ci <br /> Geologist � L � _ ed r y 12 <br /> ABOVE-GRCUND <br /> ZTY SO <br /> COWL.ETION X <br /> SPECIAL-PERMIT INFO. t _ ,�}� PJ D Ground Sulace ..� <br /> Distance to sewer line ` iJ'n n b W7, 1 q ; 2, 5' gf0wl <br /> Domestic well on site - / n ) is- 5,11- <br /> If <br /> .1If yes, location and distance - ao ; Z.9- <br /> a a -F rl .36, s S3 tr h. <br /> 4r, 54 <br /> EE <br /> SAMPLING <br /> U <br /> Holding Temperature -¢ - <br /> Method �raysl pack: <br /> Screening Method _I b <br /> Tracking Sheet n ) <br /> G <br /> i✓ - <br /> 1 3 <br /> rt. <br /> SPOILS s r_ <br /> Storage Method 5S' 1'il MATERIALS/DEVELOPMENT ,. <br /> Contamination Noted - n ) <br /> f �I <br /> , Storage Location ! ,r�L Casing type <br /> BIank 153 h. Screen_„. ft. <br /> -: Slot size Q�_02-0 <br /> M <br /> GROUTING v Bags cern <br /> T <br /> bentonite E-Wmf Buckets t <br /> Depth to water `� ✓r� - Bags sand/gravel- - h 0 _La v�f.�r� <br /> Mix Ratios p o W er -4a 1 p -4g4b, b Filter Pack type/size <br /> i <br />• '' Installation Method r �1•� -�'��''"�' Surge Block: - (Y/ n { <br /> Quantity Installed 7Z 1% /,'f r. Discussed with geologist: - y n) <br /> 14.Z1&04..4'I'ype of method t <br /> EH 29 29 D 1 o �”/�irvYi"� ;r. " <br /> AaXL <br /> -J it WrV. <br /> l0 h Cis 1pp �.' r,�E.@E ,e 30�'4?( 4 <br />