Laserfiche WebLink
16NITORING WELL INSTALLATION REPO* <br /> Date: I1 I CONS RUCTION I <br /> Premise Address: SCJ Total Depth ! <br /> Screen Length (from) (to) 4 <br /> Well No.: mil) Filter Pack (from) (o (to) <br /> Bentonite (from)_4;1-a- (to)�— <br /> Grout (from) U O (to) a c e <br /> Inspector. �7 <br /> Drilling rig type lit ase R <br /> Permit No. I Auger O.D. I.D. <br /> t� s� Completion - Stove pip isda 5o3 (circle one) <br /> Drilling Company: I f'�t'��t,t <br /> Driller. ��� casing <br /> �/' n ` height <br /> 776't <br /> ConsultanL `yL�IX1n�++-� "-' CC�.'r`; ' d <br /> 7/1 -QV <br /> Geologist <br /> ABOVEGRCUND CHS STY-30X <br /> gMPt_�CN COMPL-=TICN <br /> SPECIAL PERMIT INFO. �� nd Sufacs + <br /> grout <br /> Distance to sewer line <br /> Domestic well an site - (y n) q- It. <br /> If yes, location and distant - elf fL <br /> z_ _ <br /> = c <br /> o <br /> SAMPLING alorai = c <br /> soc'Cn <br /> Holding Teerature = gravel pads <br /> Method-74n C-777nn <br /> Screening Merhod P i O - r <br /> Tracking Sheet - (y/ n ) V <br /> 0 l y tt- <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted- ( y n ) yy�pn� - v <br /> Storage Location r ) Casmg type a v <br /> Blank fr S¢een ✓ f4 <br /> Slot size <br /> GROUTING Bags cement <br /> ( Buckets bentonite l <br /> Depth to waterer �� �}- Bags sand/gravel <br /> Mix Rad —os o i �L�Q � °i'" Filter Pack type/size <br /> Installation Method -�— Surge Block: - (y/ n ) <br /> Quantity Installed 0 Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />