Laserfiche WebLink
MONITORING WELL INSTALLATION REPO. <br /> Date: / /b CONSTRUCTION <br /> Premise Address: r >(U Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite <br /> Inspector: /rtG���-� Grout (from) -(to) <br /> / Drilling rig type <br /> t1 <br /> Permit No.ioo ,16 E7 7 Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant�� b <br /> Geologist <br /> AI&E-GROUND <br /> COMPLEf fON CHMM-BOX <br /> SPECIAL PERMIT INFO. Ground Surface C+ �.� <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) ft. <br /> If yes, location and distance - <br /> SAMPLING <br /> slatted � <br /> secdon — <br /> Holding Temperature <br /> Method ' —_ gr'yw Pack <br /> Screening Method <br /> Tracking Sheet - (y/ n ) _ <br /> 4. <br /> SPOILS �S <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) I// <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />