Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: CONSTRUCTION <br /> Premise Address:— t Y� Total Depth I -6 U <br /> Screen Length (from) lb 0 (to) c 0 <br /> Well No.: Filter Pack (from) 16 O (to) <br /> �n Bentonite (from) 9i B (to) <br /> Inspector: r YG r 1 Grout (fro ) (to) <br /> C.� �Q Drilling rig type <br /> Permit No. { a— U Auger O.D. <br /> /_ SC� Completion - Stove pip Chr�boxircleone) <br /> Drilling Company: LL%l <br /> Driller: ` casing <br /> =7 height • <br /> Consultant _qVI <br /> Geologist <br /> MOVE-GROUND <br /> COMPLETION CtiRfS?l'-80X <br /> SPECIAL PERMIT INFO. Ground Surfwo COMPLETION <br /> Distance to sewer line grout <br /> Domestic well on site - (y/n ) ft <br /> If yes, location and distance - <br /> ...Ls.z—ft. ft. <br /> b <br /> — C <br /> SAMPLING = ° <br /> slotted � <br /> aaaion — � <br /> Holding Temperature _ P <br /> Method ' _ <br /> ark <br /> Screening Method <br /> Tracking Sheet - (y/ n) <br /> l Utt. •:� - � ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) < < P ,f <br /> Storage Location Casing type V <br /> Blank ft. Screen 1 0 ft. <br /> Slot size Z _ <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 /> -7 - l � os � � `�� <br />