Laserfiche WebLink
„ ,ONITORING WELL INSTALLATION REPO <br /> Date: (—fLw l�L`I CONSTRUCTION <br /> Premise Address: rk�A Total Depth <br /> Screen Length (from) 'AO (to) <br /> Well No.: Filter Pack (from)_ (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) (to) 'D <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> (o�mp <br /> Completion - Stove pipe/ s e ox circle one) <br /> Drilling Cany: <br /> Driller: I' t'WLc� 1� casing <br /> II � � height <br /> Consultant�� 1 <br /> Geologist i,C. <br /> 7411 <br /> ABOVE-GRCUND CHAtM-BOX <br /> COMPLEf10N COMPLETION <br /> SPECIAL PERMIT INFO. Ground Suriacs <br /> Distance to sewer line proof <br /> Domestic well on site - (y/ n ft. <br /> If yes, location and distanc <br /> �.�ft. k <br /> ft. <br /> SAMPLINGaacicn <br /> ilora.l <br /> = 8 <br /> Holding Tern r tore <br /> Method l `5r ”' _ ¢"W ` <br /> Screening Method ` <br /> Tracking Sheet {y n ) Art 1r)Oi <br /> .x <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - y n ) If <br /> Storage Location Casing type <br /> Blank ft. Screen Z ft. <br /> Slot size . 67-0 <br /> GROUTING Bags cement <br /> ti Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method y� Surge Block: - (y/ i <br /> Quantity Installed Discussed with geologist: - (y n) <br /> 5 Type of method <br /> EH 29 29 <br />