Laserfiche WebLink
MONITORING WELL INSTALLATION REPO <br /> Date: '' (n CONSTRUCTION <br /> Premise AddA <br /> ress: q6, ' �R� 3 '4— Total Depth <br /> Screen Length (from) (to) <br /> Well No,,: w`w Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Kms"a f Grout (from)—(to)— <br /> Drilling <br /> from) (to)Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant_Pt 6 E <br /> Geoleeggist C n 15 1 Lr)w - T <br /> ABOVE-GROUND C4AISTY-BOX <br /> COMPLETION COMPL.EnON <br /> SPECIAL PERMIT INFO. Ground Sudan <br /> Distance to sewer line gfOut <br /> Domestic well on site - (y/ n ) 1 tt <br /> If yes, location and distance - <br /> n. <br /> SAMPLING slatted — x' <br /> 0 <br /> iiC70n <br /> Holding Temperature <br /> Method — ��pack <br /> Screening Method _ a; <br /> Tracking Sheet - (y/n ) ' _ <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratio's 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 />