Laserfiche WebLink
YONITORiNG WELL INSTALLATION REPOR"� <br /> Date: / CONSTRUCTION <br /> Premise Address: - [��� L � Total Depthy <br /> Screen Length (from) S4 _(to) Go ' <br /> Well No.: Filter Pack Ufrom)� (to) <br /> Bentonite (from) (to) _ <br /> Inspector: +� Grout (from) s ` (to)_ jZ <br /> Drilling rig type 4211 <br /> Permit No. Auger O.D. I <br /> / "�� 6a� Completion - Stove pipe/ istie Tone) <br /> Drilling Company: Com/ <br /> Driller: casing <br /> he s ght <br /> Consultant ern <br /> qv—f <br /> Ge010g1Si / "' <br /> JIX&E-GRCUND CHRtSTY43OX <br /> 00WL+rCN CGMPLECT ON <br /> SPECIAL PERMIT INFO. G=rd SurIxt <br /> Distance to sewer line �" '� preut <br /> Domestic well on site - (y/ n ) ? 0/1 <br /> tt- <br /> if yes, location and distance - - r —� ft. <br /> IVW <br /> a: d <br /> SAMPLING <br /> aocticn <br /> Holding Temperature YW <br /> ack <br /> Method 5' F <br /> Screening Method .�/ <br /> Tracking Sheet • (y/ n ) r _ <br /> SPOILS <br /> Storage Method </'- - MATERIALS/DEVELOPMENT <br /> Contamination Noted - <br /> Storage Location Casing type 5-26 �Llv A� 2-4 <br /> Blank &6 _ ft. Screen 7d fr. <br /> Slot size •02- <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios / Filter Pack type/size <br /> Installation Method / ... �"f Surge Block: - (�P n ) <br /> Quantity Installed —,;V ZFa,14Zs Discussed with geolo ist: - E$V n ) <br /> Type of method ;Zft Sa`ec/ /d <br /> EH 29 29 <br />