Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date:_ �- 12�( I p I CONSTRUCTION <br /> Premise Address: 1! C7 C) , C(01 Total Depth (� 1 <br /> Screen Length (from) 5-0 , (to) -f- <br /> Well No.: UA IA )- Filter Pack (from) V-T ' (to)— 5-0 <br /> Bentonite (from) 143 ' (to) �l 3 ' <br /> Inspector. ��tnn w� (from) 'b � <br /> Grout (to)�_ <br /> Drilling rig type <br /> Permit No. 4 -4 f Auger O.D. I,D-__ <br /> Completion - Stove pipe/ tie bo (circle one) <br /> Drilling Company: <br /> Driller: ^,,� casing <br /> t height <br /> Consultant T <br /> n VGeologist <br /> _ \ <br /> ABCVEGRCUNO <br /> CONFLETION C}Gi M-3CX <br /> SPECIAL PERMIT INFO CCMPt_`71CN <br /> ---�-�Cirwnd SLrface <br /> Distance to sewer line grout well on site-(y J n ) 1 <br /> If yes, location and distance - <br /> _ R. ft. <br /> SAMPLING o <br /> tlorai — c <br /> Holding Temperature tone" <br /> Method_ _ — yT, dPaaC <br /> �"1 n 2 0 <br /> Screening Method <br /> Tracking Sheet -g} / n ) ' <br /> - .ft. _ tt. <br /> SPOILS <br /> Storage Method_ MATERIALS/DEVEIOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location_ �, (c <br /> Casing type (t <br /> BlankCp_ft. Screen_ &t0 ft, <br /> GROUTING Slot size 020 <br /> Bags cement �v�2 <br /> Depth to water 60 ' Buckets bentonite_ <br /> Mix Ratios Bags sand/gravel ti <br /> Installation Method — �S "�'-- (AAt-u� . Filter Pack type/size <br /> Quantity Installed I o Surge Block: - (y rti- <br /> Discussed with geologist-. - ( y/ <br /> EH 29 29 Type of method CJ <br />