Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: 1 L 6 j _ CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) i(to)_ Z-0 <br /> Well No.: Filter Pack (from) ,(to) <br /> Bentonite (from) 1 (to)— 3 <br /> Inspector. �; t _ Grout (from) -Pr (to)� •— <br /> Drilling rig type <br /> Permit No. C)OA Sf Auger O.D. I.D. <br /> Drilling Company: — Completion - Stove pipe/cluistie box (circle one) <br /> Driller: casing <br /> t he?ght <br /> Consultant �► <br /> Geologist CA V, Ov`V <br /> ABOVE-Gir'I-CUND G-SZ7Y-3CX <br /> cak9L-71CN COMPUTCN <br /> SPECIAL PERMIT INFO. Ground 5uiact <br /> Distance to sewer line grout <br /> Domestic well on site - ( y/ n ) r •{t. <br /> If yes, location andAn ft. k �. <br /> 4" O <br /> w <br /> 0 <br /> C <br /> C <br /> SAMPLING <br /> sa-�cn <br /> Holding Temperatuxe o-,-L CA r <br /> Method '` — gn Vol Pack <br /> Screening Method <br /> Tracking Shcet / n ) - — <br /> _ a a •ti. I Ir aott. <br /> SPOILS <br /> Storage Method MA Q MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y') <br /> Storage Location Casing type Z pV e v:)✓ q6 <br /> Blankft Screen t S ft. <br /> SIot size , . 0-"o <br /> GROUTING Bags cement <br /> Buckets bentonite 16r,, <br /> Depth to water_ N , CWtyj--X _ B2gs sand/gravel n,, <br /> Mix Ratios Filter Pack type/size. <br /> Installation Method Surge Block: - (y/(,IT) ~c <br /> Quantity Installed Discussed with geoogist: - ( y <br /> EH 29 29 Type of method <br /> f 11 <br />