Laserfiche WebLink
,,WiONITORING WELL INSTALLATION REPS' <br /> V <br /> Date: -7 4a 5Y I _ _ __ CON STRVON <br /> 1 <br /> Premise Address: �� Total Depth <br /> ��, � � \ Screen Length (from) (to) <br /> Well No.: 1 W Filter Pack (from) 0 (to) <br /> Bentonite (from) (to) <br /> Inspector. Grout (fro ) 3 (to) <br /> Drilling rig type Gig 0 <br /> Permit No. Auger O.D. Q, (< I.D. UU <br /> Completion - Stove pipe/ a box circle one) <br /> Drilling Company: -' - _ --- <br /> Driller- casing <br /> height <br /> Consultant r <br /> Geologist_ -- <br /> A80VE-GRCUND CNAISTY-SOX <br /> CONFL.ETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Sudacs <br /> Distance to sewer lineOfOut <br /> Domestic well on site - ( n .3 Ste <br /> If yes, location and distance tt. <br /> v? m <br /> SAMPLING I i -7 slorad <br /> V Y - <br /> .y. <br /> 1 aonon <br /> Holding Temperature N <br /> Method _ <br /> Screening Method <br /> Tracking Sheet (y/ n ) <br /> 3 sP`lrs At <br /> - ' <br /> Storage Method__ MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( / ` 1 <br /> Storage Location Casing type V <br /> Blank ft. Screen �S ft. <br /> Slot size . Daft <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - ( y/ n } <br /> Quantity Installed Discussed with geologist: - (y/ n) <br /> Type of method <br /> EH 29 29 <br />