Laserfiche WebLink
`E540NITORING WELL INSTALLATION REP ' <br /> Date: �// Zoo f� /(/a2J CONSTRUCTION <br /> Premise Address:_ �s/ Jl" AIR <br /> ,2 59V Total Depth_ 73 <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from)�(to) <br /> Bentonite (from) (to) <br /> (cd <br /> Inspector: 1/VA1je4y _ Grout <br /> (from) 0 (to) <br /> Drilling rig type Ems' !0 <br /> Permit No. 9d fj'3 Auger O.D. 6� I.D._ <br /> Drilling Company:_SCompletion - Stove pipe/christie box (circle one) <br /> DEcT,�ylt'L <br /> Driller: � 7` MA-77-- casing <br /> height <br /> Consultant ,/ IL/D Z�iy✓/.e — <br /> Geologist /'4�IrC �/ w�)) T <br /> ABOVE-GROUND <br /> COMPLETION CNAISTY;rN <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surface <br /> 3r/0 grout <br /> Distance to sewer line ` <br /> Domestic well on site - (y/n ) C u) ft <br /> If yes, location and distance.- �t ft. <br /> 7�ft. <br /> O <br /> C <br /> SAMPLING <br /> secdo <br /> c4on <br /> Holding Temperaturegra= P <br /> ack <br /> Method = <br /> Screening Method =_ <br /> Tracking Sheet - (y/ n ) 1 <br /> 3 <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y rn ) IfW' <br /> Storage Location Casing type <br /> Blank = 0.5 ft. creen 2•S ft. <br /> Slot size NAC.Ro• bI-R� <br /> GROUTING Bags cement .moo <br /> r Buckets bentonite 2- <br /> Depth to wat rBags sand/gravel Z �- <br /> Mix Ratio ?w Filter Pack type/size 2�rl <br /> Installation M od Surge Block: - (y.d <br /> Quantity Installed Discussed with geologist: - (y,(n <br /> Type of method <br /> EH 29 29 <br />