Laserfiche WebLink
M' 'TORING WELL INSTALLATION REPORT <br /> `..i `r.! <br /> Well No.: ll, — <br /> G <br /> Date: CONSTRUCTION <br /> J � ` <br /> Total Depth <br /> Premise Address: _ Screen Length (from) (to) <br /> Well No.: >�!l� Z� �1.J 3 �l�.t� Filter Pack (from) (LO) <br /> Bentonite (from) (to) <br /> Inspector. ��J1.Qs Grout (from) (tO) <br /> Drilling rig type <br /> Permit No. --3 07 3 Auger O.D. <br /> Completion - Stove pipe/ stie b (circle one) <br /> Drilling Company: - it <br /> Driller. CONSTRUCTION Well No.:J <br /> Consultant J Total Depth <br /> Screen Length (from) (to) <br /> Geologist I D 1'�" —E1`f r�Y��' _ <br /> Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Grout (from) (to) <br /> SPECIAL PERMIT INFO. Drilling rig type -- <br /> Auger O.D. <br /> Distance to sewer line /// 19' _ Completion - Stove pi christie b s ( ircle one) <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance - � r , <br /> - CONS'TRUCTiON Well No.: <br /> Total Depth <br /> 1-5 <br /> Screen Length (from) (to) 0 <br /> Filter Pack (from) �s4.5 (to)� <br /> SAMPLING Bentonite (from) —(to)=& <br /> Grout (from) (to) <br /> Holding Temperature Drilling rig type <br /> Method Auger O.D. <br /> Screening Method Completion - Stove pip Christie b ( cle one) <br /> Tracking Sheet - y/ n) <br /> SPOILS <br /> Storage Method ( U MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ �V <br /> Storage Location Casing type <br /> Blank ft. Screen ft- <br /> Slot size D[ f� <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <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 />