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Geosynte& 3048 n°h°CPHD;66'3;go4g WELL COMPLETION DIAGRAM <br /> consultantsWel I ID <br /> www.geosynteacom <br /> Location: Project Name: Project Number: <br /> Start Date and Time: Finish Date and Time: Total Depth Drilled(ft bgs): <br /> Drilling Method: Drilling Contractor: Total Well Casing Depth(ft bgs): <br /> Drill Rig: Boring Diameter: Well Diameter: <br /> Depth to Water(ft bgs): Ground Surface Elevation(ft MSL): Coordinates(X,Y): <br /> Comments: Logger: Reviewer: <br /> WELL COMPLETION DIAGRAM <br /> SURFACE COMPLETION ANNULAR SEAL <br /> ❑ Flush Mount Amount Calculated <br /> ❑ Above Ground Amount Used <br /> ❑ Protective Casing ❑ Grout Formula <br /> ❑ Traffic Bollard/s Cement Type <br /> ❑ Surface Pounds of Cement <br /> ❑ Concrete ❑ Asphalt Pounds of Bentonite <br /> Cement/Bentonite Grout Gallons of Water <br /> ❑ Prepared Mix <br /> CENTRALIZERS Product <br /> Mfd.By <br /> ❑ Yes ❑ No Method Installed <br /> Number Used El Poured El Tremie <br /> Top of Bentonite Seal: <br /> Depths <br /> Top of Transitional Sand: <br /> WELL CASING BENTONITE SEAL <br /> . Top of Sand Pack: <br /> Type Amount Calculated <br /> Length Amount Used <br /> Diameter <br /> El Pellets,Size <br /> ID OD Top of Screen: El Chips,Size <br /> Product Product <br /> Mfd.By Mfd.By <br /> WELL SCREEN Filter Pack Length: <br /> SAND PACK <br /> Type <br /> Length Amount Calculated <br /> Diameter Amount Used <br /> ID OD Sand Size <br /> Slot Size Product <br /> Slot Type Mfd.By <br /> Bottom of Screen: <br /> Product Method Installed <br /> Mfd.By Total Well Depth: ❑ Poured ❑ Tremie <br /> —Borehole Depth: <br />