Laserfiche WebLink
N.wfONITORING WELL INSTALLATION REPO <br /> Date: o� Z ,�A+P / I/�l► - 4 CONSTRUCTION <br /> Premise Address: ! //� / . W , Total Depth (o <br /> (� Screen Length (from) (to) 60 <br /> Well No.: '�D ( Filter Pack (from) & (to) <br /> Bentonite (from) (to).� . <br /> Inspector: Grout (from) (to) Z <br /> Drilling rig type L- i <br /> Permit No. t) Auger O.D. I.D. 9- <br /> � Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> I M <br /> height <br /> Consultant <br /> Geologist T <br /> ABOVE-GROUND CHSLM43OX <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Suia" <br /> 7 rout <br /> Distance to sewer line Qg <br /> Domestic well on site - (y/ n) ft. <br /> If yes, location and distance - <br /> .l�ft. <br /> = m <br /> A <br /> — m <br /> SAMPLING <br /> plotted <br /> sac-don — <br /> Holding Temperature <br /> vays,Pack <br /> Method = <br /> Screening Method = " <br /> Tracking Sheet - (y/ n ) <br /> 1r�`Zft, ft. <br /> SPOILS %+b <br /> Storage Method _ MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) 2.k <br /> Storage Location Casing type , 40 <br /> Blank (Gp ft. Screen 5- <br /> ft. <br /> Slot size . �l <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size 3 <br /> Installation Method Surge Block: - (y/n) <br /> Quantity Installed Discussed with geologist: - (y/n ) <br /> Type of method <br /> EH 29 29 <br />