Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> J <br /> Date:_ <br /> CONSTRUCTION <br /> Premise Address:�j Total Depth J6b <br /> Well No.:- Screen Length (from) 3 <br /> Fflter Pack (from)_33'— S (to) <br /> �=Sso <br /> Inspector: _ Bentonite (from) - 3` (to)_5E_��,• <br /> P C1�� �A �.- Grout (from)_ <br /> Permit No. Drilling rig type <br /> Auger O.D. I.D. <br /> Drilling Company-Com an Completion - Stove pipe/chrisde box (circle one) <br /> S'� �.�� o <br /> Driller: Trn,r <br /> casing <br /> Consultant I height <br /> Geologist <br /> A.°CVE-GRMND <br /> CCMPL`r ON GHR7STY-3oX <br /> SPECIAL PERMIT INFO. CCMPL_EMCN <br /> Cxa:c�d Stztacs <br /> Distance to sewer line oralt <br /> Domestic well on site - (Y/ n ) <br /> If yes, location and distance - ft. <br /> SSA DUNG _ c <br /> 110rwi c <br /> Holding Temperature_ <br /> Method_ L ( 7 <br /> f M7 <br /> F, <br /> Screenin; Method <br /> Tracking Shcet - n ) <br /> Storage Method <br /> MATERIALS <br /> Contamination Noted - y ) /DEVEI OPMENT <br /> Storage Location <br /> IL YSrS Blank type 2 VC <br /> ft Screen h, <br /> GROUTING Slot size -020 <br /> Bags cement <br /> Depth to waterBuckets bentonite <br /> ti Zv 1 <br /> Mix Ratios Bags sand/gravelj 5 <br /> 3G <br /> Installation Methods Filter Pack type/size <br /> Quantity Installed �� Ct4 rSurge Block: - (y/1 <br /> Discussed with geologist: - (y/0 <br /> EH 29 Z9 Type of method <br />