Laserfiche WebLink
MONITORING WELL INSTALLATION REPuRT <br />Date: UN <br />Premise Address: Sod L-), O�kvv, � fav, <br />Well No.: '�\ K -� <br />— <br />Inspector: W V10-14 <br />Permit No. <br />Drilling Company: <br />Driller: <br />Consultant �k ff r <br />Geologist_ rN <br />SPECIAL PERMIT INFO. f <br />Distance to sewer line <br />Domestic well on site - ( y / n) 3 G <br />I1 yes, location and distance - I <br />SS <br />S <br />SAMPLING <br />Holding Temperature <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 />Depth to water <br />Mix Ratios <br />Installation Method <br />Quantity Installed <br />EH 29 29 <br />CONSTRUCTION <br />Total Depth <br />Screen Length (from) <br />(to) <br />Filter Pack (from) <br />(to) <br />Bentonite (from) <br />(to) <br />Grout (from) <br />(to) <br />Drilling rig type Y K <br />Auger O.D. 14 I.D. 1 S <br />Completion - Stove pipe/christie box (circle one) <br />casing <br />F1height <br />'4 <br />ABCVE-G, iC(JND <br />COMPLET{ON <br />�1 21.1 V-111, <br />M <br />0 <br />soc°icn <br />.41 <br />P'avol pxsc <br />o <br />MATE RIALS/DEVELOPMENT <br />M <br />Casing type, S• S �L <br />Blank --L o ft. Screen 2. o ft. <br />Slot size C) .20 <br />Bags cement <br />Buckets bentonite <br />Bags sand/gravel <br />Filter Pack type/size 3 - i --- <br />Surge Block: - ( y / n ) <br />Discussed with geologist: - ( y / n ) <br />Type of method <br />