Laserfiche WebLink
MONITORING WELL INSTALLATION REP^''T <br /> Date:_ /b�� O'7- CONSTRUCTION <br /> Premise Address: > <br /> Total Depth0 6-�f(5 <br /> _ �f9 S <br /> �� 2 Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) <br /> Inspector; Grout (from) (to) <br /> S�. �a �� Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> c Completion - Stove pipe/cluistie box (circle one) <br /> Drilling Company; L <br /> Driller: casing. <br /> r f L height <br /> Consultant <br /> Geologist <br /> APAYE-GROUND <br /> CO PP L ETIO N C?-A:STI'-30X <br /> C0XA'L='TICN <br /> SPECIAL PERMIT INFO. Chou Sulacy <br /> Distance to sew r line orec <br /> Domestic well n site - (y/n) It. <br /> If yes, locatio and distance - • <br /> K. . <br /> — M <br /> SAMPLING <br /> Holding Temperature .7 <br /> Method <br /> Screening,Meth d <br /> Tracking Sheet / n ) <br /> ft. 14 rtt. <br /> SPOILS / <br /> Storage Method N!'4 MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ ) <br /> Storage Location Casing type <br /> Blank ft. Screen fT <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets be onite <br /> Depth to water S"U Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> -ijnstalladon Method `�......� -te- Surge Block: - (y/ n ) <br /> Quantity Installed Discussed vrith geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29. . <br />