Laserfiche WebLink
JNITOR1NG WELL INSTALLATION REPO. <br /> Date: `t � / Q � CONSTRUCTION / <br /> Premise Address : �4"/ C � w ` Total Depth <br /> Screen Length (from) (to) 4.s <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to)4_ <br /> Inspector: SC� I (�7� 'fy� Grout (from) (to) 8 - <br /> Drilling rig type i%" (; <br /> Permit No. q l � 67¢ Auger O.D. O . 2. <br /> Completion = Stove pi cluistie bo (circle one) <br /> Drilling Company: PIfG/l�S>3Yl /,.i'u(-LIi�Y, <br /> Driller: L/ uxlg-LL- casing <br /> n / � = � <br /> Consultant l � C�D/J5 I cA( � height <br /> ✓ P '4' <br /> Geologist 2� 2j - <br /> A80VE1 EfbN CUND <br /> COMPLECHRISTY-aCX <br /> COMPLETICN <br /> SPECIAL PERMIT INFO. Gfound Sudan <br /> Distance to sewer line <br /> I grcut <br /> Domestic well on site - ( y /moi tt, <br /> If yes, location and distance - <br /> N / ft tt. <br /> Ma <br /> SAMPLING elcgad = c <br /> Holding Temperature 9t °G = G <br /> Method '� < ' G 0 P3 = <br /> Screening Method // <br /> Tracking Sheet - j n ) <br /> IF <br /> ft, = fL <br /> SPOILS <br /> Storage Method -67bt beam 6 MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y / ry ) <br /> Storage Location DN sinr Casing type �i� 40 P✓c� <br /> Blank7 ft. Screen <br /> Slot size t'� • 0zc7 <br /> GROUTING - - Bags cement - <br /> ( Buckets bentonite 194�- <br /> Depth to water 6 ;Z Bags sand/gravel <br /> Mix Ratios C aL Filter Pack type/size <br /> Installation Method Surge Block: - ( n ) <br /> Quantity Installed Discussed with geologist: - ( y / n ) <br /> Type of mediod <br /> EH 29 29 <br />