Laserfiche WebLink
d (( .. <br /> i <br /> k AONITORING WELL INSTALLATION R]14 <br /> j <br /> Date: Tri)I�j k 6 //�� CONSTRUCTION <br /> I LIF <br /> Premise Address: ��� I`o�iw+ �lt�'J Total Depth <br /> �w / Screen Length (from) (to) <br /> Well No.: / rt� �_ Filter Pack (from) (to) <br /> !s Bentonite (from) (to) j <br /> Inspector. _�QIAMi� Grout (from) (to) <br /> .j. q2)— d Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> ! Completion - Stove pipe/cluistie box (circle one) <br /> Drilling Company: D k�,I-�vtu 1�tiP�PiLI�IS <br /> I! I <br /> Driller: Leo (o Iur'ltom casing <br /> n / " Ing hetgh° <br /> Consultant tt��R ( rC''DSGles1LPS <br /> E <br /> Geologist -X> Lq ��L�-tL ABOVE-GRCUNO G#iIST f e0X <br /> i lCOWLETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Sufaca <br /> i T <br /> Distance to sewer line 5 Orart <br /> Domestic well on site - (y <br /> If yes, location and distance�- ft- <br /> 22 ft <br />! SAMPLING alorads, <br /> I sacion '. <br /> Holding Temperature _ gm„d� <br /> Method ILP A/�D.aY� � LGA p t6t <br /> 1 au <br /> Screening Method <br /> Tracking Sheet - n ) <br /> SPOILS <br /> Storage Method ii MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n) 2 `( <br /> Storage Location Casing type <br /> Blank 'O ft. Screen ft. <br /> Slot size • V-Lf) <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bagssand/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 /> i <br />