Laserfiche WebLink
`%% .dONITORING WELL INSTALLATION REPbPW <br /> Date: l6 9 d g CONSTRUCTION ,1 <br /> Premise Address:— Z66.2— A Total Depth V <br /> Screen Length (from) (to) <br /> Well No.: ��/'3 Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) to) <br /> �p �v Drilling rig type <br /> Permit No. S; Q� .J�� Auger O.D. 19 I.D. <br /> ,/'�, , / Completion - Stove pipe/christie box (circle one) <br /> Drilling Comptany:` / !�/ <br /> Driller:_ /�1 -�- f t casing <br /> height <br /> Consultant ' d i <br /> Geologist <br /> ABOVE-GROUND CtiR�STY-8OX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surfacs <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - <br /> C <br /> £ O <br /> SAMPLING slotted = c <br /> &wdar1 :i• _ '' <br /> Holding Temperature <br /> ack <br /> Method _ �`�P <br /> Screening Method <br /> Tracking Sheet (y/n ) <br /> w <br /> SPOILS �-- <br /> Storage Method5�5 ejx MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) All <br /> Blank <br /> �� <br /> Storage Location Casing type a <br /> Blank d ft. Screen 2,0 ft. <br /> Slot size _OZD "' <br /> GROUTING Bags cement 17 <br /> Buckets bentonite / <br /> Depth to water Bags sand/gravel <br /> Mix Ratios /-// Filter Pack type/size <br /> Installation MethodVEI�PFSurge Block: - (y n <br /> Quantity Installed_ j 1: Discussed with geologist: - (y n) <br /> Type of method <br /> EH 29 29 <br /> 161 9/j' <br />