Laserfiche WebLink
IWPJNITORING WELL INSTALLATION REPO., i <br /> IS n <br /> Date: CONSTRUCTION <br /> �"I � I <br /> Premise Address: S S Total Depth <br /> Screen Length (from) 7D (to) la$ <br /> Well No.: Filter Pack (from) -1 D (to) 1 - . <br /> Bentonite (from)— V, 5 (to) G <br /> Inspector. `7mrn a Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company S <br /> �Driller: T' height casing <br /> Consultant— w <br /> Geologist <br /> ABOVE-GROUND <br /> CONN fiTION C>1AlSiY ON <br /> CN <br />' SPECIAL PERMIT INFO. Ground SuAan <br /> Distance to sewer line <br /> grout <br /> Domestic well on site - (y/ n) tt, <br /> III If yes, location and distance - g, <br /> G o = O <br /> SAMPLING slotted <br /> socicn <br /> Holding Temperature gravel PaCK <br /> Method <br /> Screening Method <br /> Tracking Sheet - (y/ n ) ` <br /> SPOILS <br />' Storage Method 0-f\- f MATERIALS/DEVELOPMENT <br /> Contamination Noted - y n ) � <br /> Storage Location Casing <br /> Blankgft. Screen ft. <br /> Slot size 0 1 <br /> GROUTING Bags cement <br /> f r Buckets bentonite N1/ <br /> 1 Depth to water 5 S Bags sand/gravel <br /> Mix Ratios 5 Uv ✓//6S Filter Pack type/size a4 1 a- <br /> Installation Method Surge Block: - ( y/ n ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br /> I <br />