Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br />Date: ^fj <br />Premise Address: �a4At,1�f�Lo <br />Inspector: o_cvr gd <br />Permit No. 2-- 674 <br />Consultant <br />Geologist <br />SAMPLING <br />Holding Temperature <br />Method <br />Screening Me <br />Tracking Sheet (y/n) <br />SPOILS <br />StorageM hod <br />Contaminaten oted - yes/no <br />Storage Lo on. <br />SPECIAL PERMIT INFO. <br />Distanc>we <br />se line <br />Domestion site - yes/no <br />If yes, te n & distance - <br />GROUTING / <br />r <br />10 <br />Depth to water �, -71 <br />Mix Ratios <br />Installation Method m <br />Quantity Installed <br />CONSTRUCTION <br />Well No._ <br />Total Depth f <br />Screen Length '2o° <br />Filter Pack <br />Bentonite Pellets .3t <br />Grout 65 U X <br />Completion -Stove pipe ch istie bow <br />Auger O.D. <br />Auger I.D. <br />if <br />_ . <br />\AN�/ <br />AE;;VE4ROtJND <br />COMPLETION «• <br />'112M -4L' - ---- <br />COMPLETION <br />®tt. <br />slotted <br />vection <br />®®®it. <br />MATERIALS USED: <br />®rout <br />ft. <br />1 ft. <br />Casing type �aL r¢® <br />Ale - <br />Blank ft. Screen ft. <br />Slot size <br />Bags cement <br />Buckets bentonite <br />Bags sand/gravel <br />Filter Pack type/size <br />