Laserfiche WebLink
WNITORING WELL INSTALLATION REP* <br /> Date: <br /> CONSTRUCTION <br /> Premise Address: <br /> Total Depth <br /> Well No.: Screen Length (from) (to) <br /> Filter Pack (from) <br /> Inspector. Bentonite (from) (to) <br /> Grout (from) (to) <br /> Permit No. Drilling rig type <br /> Auger O.D. I.D. <br /> Drilling Company: Completion - Stove pipe/clu-istie box (circle one) <br /> Driller: <br /> casing <br /> Consultant height <br /> Geologist <br /> A3CVE-GACQND <br /> CJA�L_�CN CNAJSTY-aCX <br /> SPECIAL PERMIT INFO. GCCMPL–=71ON <br /> Ground Surface <br /> Distance to sewer line <br /> Domestic well on site - (Y n ) grout <br /> If yes, location and distance <br /> - O <br /> SAMPLING <br /> Ifor.Da� <br /> Holding Temperature sx�cn B <br /> Method = VIvIW Pack <br /> Screening Method — <br /> Tracking Sheet - (y/ n ) _ <br /> SPOILS <br /> Storage Method MATERIAIS/DEVEI.OPMENT <br /> Contamination Noted - (y/n ) <br /> Storage Location <br /> Casing type <br /> Blank ft. Screen <br /> GROUTING Slot size <br /> Bags cement <br /> Depth to water Buckets bentonite <br /> Mix Ratios Bags sarnd/gravel <br /> Installation Method Filter Pack type/size <br /> Quantity Installed Surge Block: - (y/ Il ) <br /> Discussed with geologist: - ( y/ n ) <br /> EH 29 29 Type of method <br />