Laserfiche WebLink
MONITORING WELL INSTALLATIOij REPORT <br /> Date: CONSTRUCTION <br /> Premise Address: 6 d 3 3 M',e4,N' _�5 7 tz1 Total Depth 7) <br /> Scraen Length (from)' "7" _ (to)_ tj 2_ <br /> Well No.:__ l�_S - (; 2 Filter Pack (from) Z — <br /> ' v Bentonite" (from) Z � (to) <br /> Inspector. _ �,>> v1►1�i /iV u k �,,� Grout (from) -� ' �(to)--O— <br /> Drilling rig type C ti <br /> Permit No. Auger O.D. % I.D. <br /> Completion tove pip christie box (circle one) <br /> Drilling Company:__ CC1sG� - <br /> Driller:__ /(2 { v Sci la Z 4 r �` casing <br /> height <br /> Consultant <br /> Geologist_ <br /> ABOVE-GROUND <br /> cowLET{ON �/ CJiRZ Y-BOX <br /> SPECIAL PERMIT INFO. --__ COMPLETION <br /> �. �.nd SLdacs <br /> Distance to sewer line �rcxrt <br /> Domestic well on site - (y/n) <br /> If yes, location and distance <br /> .I <br /> SAMPLING — o <br /> BIOttBd <br /> Holding Temperaturecn <br /> Method = <br /> gr vs?Pacfc <br /> Screening Method = <br /> Tracking Sheet - (y/n) _ <br /> _ft. `" ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location Casing type�G A �Q PVL <br /> Blank `12' ft.lhjs Screen <br /> Slot size C, 0 X.C} <br /> GROUTING Bags cement <br /> Buckets entonite2 u,;s <br /> Depth to water 7 Bagssan gravel ;Zi <br /> Mix Ratios Filter a type/ 'ze_�enu�ro <br /> Installation Method `�:,rn m;r yh rr,v�_ti /( ,����r: `_. S.urge_Block: - n_) <br /> ' Quantity Installed _ —�- � — <br /> Discussed with geologist: - (y/n) <br /> EH 29 29 <br /> Type of method <br /> • <br />