Laserfiche WebLink
,AGE OF <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: /O/ IQ 0 CONSTRUCTION <br /> Premise Address: 1100 d'tit uJ/y Well No. <br /> Inspector• Total Depth _ <br /> �. Screen Length '-68 <br /> Filter Pack 6A -�"i <br /> ^ Z�S 7 Bentonite Pellets "7 <br /> 4 -� <br /> Permit No. 0 Grout -4 <br /> Consultant t4s ? Completion-Stove pipe christie box <br /> Geologist /'tVll� � /'�l�'�_ <br /> Auger O.D. /D.ZS <br /> Auger I.D. �S.Z <br /> SAMPLING ---- <br /> Holding Temperature <br /> Ta stldc-Up <br /> Method Ica— <br /> —W <br /> Screening Method .. T <br /> A$OVE-GROUND CHRISTY-BOX <br /> Tracking Sheet y n) COMPLETION COMPLETION <br /> Ground Surface + -� <br /> SPOILS <br /> grout <br /> Storage MethodDeft <br /> Contamination Noted - yes no <br /> storage Location <br /> 6AJ 52097- <br /> SPECIAL <br /> 20 SPECIAL PERMIT INFO. <br /> 0 <br /> S r slotted 'E <br /> Distance to sewer line secion <br /> Domestic well on site - yes no — gra <br /> P <br /> If yes, location & distance - <br /> _...,ft. ack <br /> GROUTING <br /> MATERIALS USED: <br /> r Q+' ` '/ J <br /> Depth to water /"/ Casing type ¢{} AIC �¢ <br /> Mix Ratios Blank_ ft. Screen' ft. <br /> Installation Method Slot size 0. 0.10 <br /> Quantity Installed Bags cement <br /> Buckets bentonite 411> <br /> Bags sand/gravel <br /> Filter Pack type/size �7J <br /> Total Billed Time Per Site <br /> Date Permit Finalized <br />