Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: Z.2. CONSMUCTION <br /> Premise Address: V <br /> Total Depth <br /> Screen Length (from) 33 <br /> Well No.: Filter Pack (from) _� (to) (5 <br /> - (to)—-5A <br /> Benconire (from)_ (to) A a- <br /> Inspector- Grout (from) —(to) <br /> Drilling rig type <br /> Permit No. oo Auger O.D. I.D. <br /> Drilling Company:,.—(.A)-OA�Moti� Completion - Stove pipe/cluistie box (circle one) <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist.......................... 14A1k�_ 01,lil6vi— <br /> AWVE-GRCijND <br /> CONFLETION C4_R*'TY_80X <br /> SPECIAL PERMIT INFO. COMPLEMN <br /> + It t <br /> Distance to sewer line proal <br /> Domestic well on site - ( y/ n <br /> If yes, location and distance • 30%a <br /> 2.- <br /> SAMPLING <br /> aocicn <br /> Holding Temperature ovti C, <br /> Method <br /> V2 W P&* <br /> Screening, Method <br /> Tracking Sheet n <br /> SPOILS <br /> Storage Method La MATERTALS/DEVEI.OpMENT <br /> Contamination N—oted <br /> Storage Location <br /> Casing type Z, p\1 <br /> Blank_A4 ' ft. Screen <br /> GROUTING Slot size.- , 0-Lo <br /> Bags cemenr---2-, <br /> Depth to water Buckets bentonite— I <br /> Mix Ratios Bags sand/gravel- i <br /> Installation Method Filter Pack type/size <br /> Quantity Installed— /U Surge Block: - ( y/0 <br /> Discussed with geologist: y Itij-5 <br /> EH 29 29 Type of metliod <br />