Laserfiche WebLink
'11ONITORING WELL INSTALLATION REP6n <br /> Date: I Z CONSTRUCTIO <br /> N / <br /> Premise Address:_ 1717 5 - S� Total Depth bG <br /> Well No.: laa) <br /> Screen Length (from) 5-,E (to) <br /> Filter Pack (from) 60 (to) <br /> Bentonite (from) (to)� <br /> Inspector: Grout (from (to) <br /> Drilling rig type - z <br /> Permit No. 7 7 Auger O.D. I.D. 51 <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Comp/any: (71-�-Sf' <br /> Driller: b 7�V casing - <br /> U height <br /> Consultant_DD� <br /> Geologist <br /> ABOVE-GROUND <br /> COMPLETION DPLE71 <br /> SPECIAL PERMIT INFO. Ground SuAace <br /> y i <br /> Distance to sewer line / grout <br /> Domestic well on site - (y/ n ) ft <br /> If yes, location and distance - <br /> _ <br /> = m <br /> m <br /> SAMPLING slotted _ c <br /> .G section <br /> Holding Temper. ture <br /> Method ;Iru - v/L� ? �-+6Q^ _ gavel <br /> pack <br /> Screening Method jO _ <br /> Tracking Sheet - n ) <br /> ft. ft. <br /> SPOILS �c 60 <br /> Storage Method �S� Dme f' MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y <br /> Storage Location Casing type <br /> Blank ft. Screen !O ft. <br /> Slot size O 6 <br /> GROUTING Bags cement <br /> Buckets bentonite Af ICA-7" <br /> Depth to water %ZS Bags sand/gravel�S <br /> Mix Ratios Filter Pack type/size a//(o <br /> Installation Method Surge Block: - (y --� <br /> Quantity Installed Discussed with geologist: - (y/O <br /> Type of method <br /> EH 29 29 <br /> r' <br />