Laserfiche WebLink
MONITORING WELL INSTALLATION 10ORT <br /> Date: CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from)-(to)- <br /> Inspector: <br /> from) (to)Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: T casing <br /> t height <br /> Consultant T <br /> _ T <br /> Geologist ABOVE-GROUND <br /> COLVLET10N CNAISTY <br /> COMPL.°MONTiON <br /> SPECIAL PERMIT INFO. Ground SuAx+ + <br /> grout <br /> Distance to sewer line <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - tL <br /> ft. <br /> O <br /> C <br /> O <br /> SAMPLING dotted = c <br /> w=on <br /> Holding Temperature = Ram Pack <br /> Method <br /> Screening Method <br /> Tracking Sheet - (y/ n ) *. _ <br /> n = IF tL <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type Et <br /> Blank ft Screen <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bagssand/ <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - ( y/n ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />