Laserfiche WebLink
ft. <br />ABOVE-GROUND <br />COMPLETION <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />Ground Surfac• <br />MATERIALS EVELOPMENT <br />grout <br />ft. <br /> ft <br />slotted <br />secjon <br />ft. <br />f111611 6111/1- <br />MONITORING WELL INSTALLATION REPORT <br />Date: <br />Permit No. <br />Drilling Company: <br />Driller: <br />Consultant <br />Geologist <br />SPECIAL PERMIT INFO. <br />Distance to sewer line <br />Domestic well on site - ( y / n ) <br />If yes, location and distance - <br />SAMPLING <br />Holding Te erature <br />Method <br />Screening Method <br />Tracking Sheet - y / n) <br />SPOILS <br />Storage Method <br />Contamination Noted - ( y / n) <br />Storage Location <br />GROUTING <br />s-- <br />Depth to water <br />Mix Ratios <br />Installation Method <br />Quantity Installed <br />CONSTRUCTION <br />Total Depth <br />Screen Length (from) (to) <br />Filter Pack (from) (to) <br />Bentonite (from) (to) <br />Grout (from) (to) <br />Drilling rig type <br />Auger 0.D. I.D. <br />Completion - Stove pipe/christie box (circle one) <br />Casing type <br />Blank <br /> <br />Screen <br />Slot size <br />Bags cement <br />Buckets bentonit <br />Bags sand/grav <br />Filter Pack typ size <br />Surge Block: - ( y / n) <br />'Discussed wi geologist: - ( y / n) <br />Type of me od <br />Premise Address: 2 <br />itd <br />Well No.: / 3 <br />Inspector: <br />EH 29 29