Laserfiche WebLink
�VITORING WELL INSTALLATION REPO.; <br /> Date: CONSTRUCTION <br /> Premise Address: �(Zg Total Depth �� r <br /> Screen Length (from) z5 • (to) O Well No.: Filter Pack <br /> (from} Z (to) 8 <br /> Bentonite (from) (to) � <br /> Inspector: Grout (from) ` <br /> (to) d <br /> 9/ /�y Drilling rig type 5 - ���3U Z5 6 <br /> Permit No. Auger O.D. O LD. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant 1t> T <br /> Geologist k bey' -� T <br /> ABOVE-GROi.1ND <br /> COMPLETION CHRISTI'-BOX <br /> OlNPLETION <br /> SPECIAL PERMIT INFO. <br /> Ground Suriact <br /> 7 <br /> Distance to sewer line grout <br /> Domestic well on site - (y/(f)) ft. <br /> If yes, location and distance - <br /> j.. a <br /> D <br /> SAMPLING slotted = S <br /> section <br /> 0 <br /> Holding Temperature OZg:MV91 Pack <br /> Method ,. -,. ,a;0-7�T— — <br /> Screening Method /Vu <br /> Tracking Sheet y n ) 25 — <br /> it. ZS ft. <br /> SPOILS <br /> Storage Method_ k)t s5 v—� MATERIALS/DEVELOPMENT <br /> Contamination Noted - `�'}y/ n ) � / <br /> Storage Location 6� G „_.,.,-•-•---.,,., Casing type `{,, / �'`C <br /> Blank /U ft. Screen / ft. <br /> Slot size 0 I D <br /> GROUTING Bags cement <br /> Buckets bentonite_ <br /> Depth to water {� �(#Vl Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - (0/ n ) <br /> Quantity Installed Discussed with geologist: - y n ) <br /> Type of method ZOM <br /> AW <br />