Laserfiche WebLink
MONITORING WELL INSTALLATION REPOr�f <br /> ' I <br /> Date:, CONSTRUCTION <br /> Premise Address:�E�'�le &) 41,G Total Depth Z • S <br /> Screen Length (from) Z` (to)-=. <br /> Well No.: Filter Pack (from)77W, (to) 107 <br /> Bentonite (from) (to).' S <br /> Inspector: Grout (from) (to).` d <br /> # Drilling rig type Gr- <br /> Permit No, 44Z �Z�2 9 Auger O.D. $ I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: f <br /> Driller: f au ffs casing _ <br /> ��__ • height. <br /> Consultant <br /> Geologist <br /> ABOVE-GROUND <br /> COMPLETION ' tSTY-BOX <br /> SPECIAL PERMIT INFO. - Gcound Surface <br /> ? x pram _ <br /> Distance to sewer line <br /> Domestic well on site - (y 110 - �" �• <br /> if yes, location and distance - fta <br /> 4 �+ N •yam., r -i,�"tigeYf' j•*, '' ; '"tw ;, _ m r <br /> SAMPLING 3, g � r r►..+ �, slotted y _ k `- , <br /> Holding Temperature • % ''` w "*' w. r _ }' Qnvg!'paCk <br /> Method <br /> Screening Method = <br /> Tracking Sheet - C-y/ n <br /> Ilk ft. <br /> . SPOILS <br /> Storage Method ✓�x _ MATERIALS EVELOPMENT <br /> Contamination Noted'- (y/ n )w :, ,' b <br /> '' w * Casing type 2 -5eJh P'1�� F <br /> n <br /> Storage Locatio :i <br /> Blank `1 ft. Screen.: S <br /> Slot size - 074-011 <br /> GROUTING Bags cement t <br /> ". ;< w,,- n p ,-" Buckets bentonite <br /> Depth to water <br /> Bags sand/gravel (o <br /> Mix Ratios. : t . A16 Filter Pack type/size -Z 12- <br /> Installation Method_ J96u-s_ Surge Block: -®n) $'`d--ap• ti¢'° <br /> Quantity Installed T <br /> 3 " •� i`wv" •Discussed with geologist: - (y n <br /> A ` ype of method # <br /> EH 29 29 tit � �- � .�;,, ��•*, ,.' �.�'�- , �,� � '�, . � `� �, ,,,�_ . ,� �-- X <br /> v i <br />