Laserfiche WebLink
4E of <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: +� ,' f�/ I L� CONSTRUCTION <br /> Premise Address: / 5- S�oC-/��7J i (`;P�� Well No. AWAL <br /> In ector: Total Depth �-/� <br /> c'�� r Screen Length o ' c� S -.- <br /> Filter Pack <br /> Bentonite Pellets <br /> Permit No. Grout t <br /> Consultant <br /> Geologist Completion-Stove pip Christie box <br /> Auger O.D. <br /> Auger I.D. 3 <br /> SAMPLING <br /> Holding Temperature stIck'uP <br /> Method <br /> Screening Method <br /> ABOVE-GROUND CHRISIY-BOX <br /> Tracking Sheet (y/n) COMPLETION COMPLETION <br /> SPOILS Ground Surface <br /> proof <br /> Storage Method ZZ, <br /> Contamination Noted - yes/no n• <br /> Storage Location ft. <br /> ft. <br /> _ a <br /> SPECIAL PERMIT INFO. _ • <br /> _ c <br /> 0 <br /> slotted <br /> Distance to sewer line section _ $ <br /> Domestic well on site - yes/no = gravel pack <br /> If yes, location & distance - <br /> GROUTING <br /> MATERIALS USED: <br /> / V <br /> Depth to water. _��Ca Casing type �- <br /> Mix Ratios Blank .3s ft. Screen !U ft. <br /> Installation Method Slot size <br /> Quantity Installed Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel <br /> Filter Pack type/size <br /> Total Billed Time Per Site <br /> Date Permit Finalized <br />