Laserfiche WebLink
viONITORING WELL INSTALLATION REPO" <br /> Date: y 7 CONSTRUCTION <br /> Premise Address: �S �� Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: /< � Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> i <br /> Driller: casing <br /> n height -QW7F <br /> Consultant 1 t`�i <br /> Geologist •- <br /> ABOVE-GROUND CHRISTY480X <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surface / <br /> Distance to sewer line of0� <br /> Domestic well on site - (y/ <br /> ft. <br /> If yes, location and distance - <br /> ft. ft. <br /> m <br /> 3 <br /> SAMPLING slottad�� — c <br /> � <br /> sectcn <br /> Holding T erature gra';W Pack <br /> Method ��. <br /> Screening Method p i Ij 2�> /v►-c�G. '` — <br /> Tracking Sheet n ) 4 <br /> SPOILS <br /> Storage Method MATERIALS EVELOPME <br /> Contamination Noted - (y <br /> Storage Location Casing type / <br /> Blank ft. ' Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water —� Z Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - f y/ n ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />