Laserfiche WebLink
MONITORING WELL INSTALLATION REP <br /> Date: ����lo CONSTRUCTION <br /> TT <br /> Premise Address: w '�l _l �d U Total Depth <br /> // (J Screen Length (from) (to) <br /> Well No.: "�g(,6) Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> 1 Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: RV <br /> Driller: casing <br /> �^ height <br /> Consultant <br /> Geologist <br /> ABOVE-GROUND <br /> COMPLETION COMPLEnON <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Suriacs <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - ft. <br /> ft. <br /> ft. <br /> _ p <br /> o <br /> SAMPLING slanad <br /> sac'on —_ <br /> Holding Temperature = 71Pack <br /> Method = <br /> Screening Method <br /> Tracking Sheet - (y/n ) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <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 />