Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> -� r\ <br /> MW <br /> ZQo'� CONSTRUCTION <br /> Date <br /> . ,'� Ui�—�"� Total Depth <br /> Premise Address:_______ Screen Length (from) (t°) 4 <br /> "s4telp <br /> MW Filter Pack (from) (to) `' <br /> Well No.: SGC "1 Bentonite (from) 4' (Co)�— <br /> Grout (from) (t0) <br /> Inspector. Drilling rig type <br /> Auger O.D. I.D. <br /> Permit No. Completion - Stove pipe/Christie box (circle one) <br /> Drilling Company: <br /> casing <br /> Driller• T height <br /> • 1.1 <br /> Consultant __-_-5 T <br /> Geologist >P c ^�1P- -----------���\,r ,_q AB0VE-GRCUND C,}¢t:STY 30X <br /> 'V 1 COMPLET{ON coWPLETICN <br /> Ground surfaxs <br /> SPECIAL PERMIT INFO- `4 <br /> �� prcc.K <br /> Distance to sewer line _:,f t. <br /> Domestic well on site - (y/ n) ft. <br /> If yes, location and distance - P V SCYG P �_ft <br /> SAMPLING txicn <br /> Holding Temperature �e = �v91 page <br /> Method <br /> Screening Method =' _ <br /> Tracking Sheet - (y/n)--- <br /> SPOILS <br /> y/n)SPOILS <br /> - V l(,�ar MATERIALS/DEVEi.OPMENT <br /> Storage Method �-- <br /> Contamination Noted- (Y/ n) Casing type - �ft <br /> Storage Location gl� fc. Screen <br /> �—M'Buckets <br /> Slot size <br /> Bags cement -- <br /> GROUTING bentonite <br /> Bags sand/gravel <br /> I <br /> Depth to water MW MWFilter Pack type/size <br /> Mix Ratios Surge Block: - (y/ 11 ) <br /> -installation Method � Discussed vAth geologist: - (y/ n) <br /> Quantity installed ti. Type of rnctllod <br /> EH 29 29 i� % <br />