Laserfiche WebLink
RLTONGEOSCIENCE 16-:352-87'92 AFF; �, " 92 10 26 ko . 005 P . 05' <br /> At w4 <br /> MONMRINO WELL INSTALLATION REPORT <br /> i <br /> Date A <br /> CON5RV1'ION <br /> 16 v3rT <br /> Premise Address t Well No. /h G✓�/p <br /> inspector: M;tr Cb/lln� <br /> Total Depths � <br /> Screen Length <br /> Filter Pack _ S' <br /> Bentonite ielleta 5 <br /> Permit No. OrolAt Il <br /> Consultant -'A 77"" Cco ft�'e1%LA completion-stove pigs hrzstie bo <br /> Geologist !►r►ATTf ✓ <br /> Auger O.D. m� r' <br /> Auger I.D. ,I <br /> SAMPLING <br /> ! �ifelt i <br /> Halling Temperature <br /> Method <br /> Screening Method _ • <br /> ABOVE-OROU1Vp' #iISTY•90X <br /> Tracking Sheet (y/n) 001OL&ION <br /> OOMPLMN <br /> FOILS I� � C3roatn�Slrtac� ,� , <br /> proof <br /> Storage Method c,��,'Ir.( d f�/�f rc f. C tvorl / <br /> Contamination Noted - yes/no • <br /> storage Location ' ft- <br /> ' �.,(t. ..,,. <br /> i <br /> V <br /> UMCI — w <br /> AL PERMXT INFO. <br /> Waned � 1 <br /> Distance to sewer line a�cddn <br /> Domestic well on site - yes/no <br /> If year location & distance i <br /> r r, <br /> v <br /> MA-TERTALS USED: <br /> Depth to water �sg Ype._!�-! <br /> Casi.n t <br /> Mix Ratios i.+-t� A`iil <br /> 'C Blank'I S'� ft. Screen O ft. <br /> Installation Method , .'Treo,�r- Slot 4ixer!1 __Q.,OAO .,CA <br /> ` gmantity Installed - -_^-2 y.0 Bags cement <br /> Buckets bentonite .5- <br /> Bags sand/ <br /> gravel <br /> y---. ----- <br /> Filter Pack type/size A,-'O, <br /> R � • � yY <br /> • 4 <br />