Laserfiche WebLink
"...• PW6E OF 3 <br /> MONITORING WELL INSTALLATION REPORT <br /> / <br /> Date: l� Z � CpNSTRUCTION <br /> Premise Addreps: �G �• �ITIr Sf We11 No. -#-Z" <br /> Inspector: Total Depth ?-C Screen Length <br /> Filter Pack cwt• <br /> Bentonite Pellets­ <br /> Permit <br /> Permit No. /U. ��I Grout <br /> Consultant . - Completion-Stove pip /christie box <br /> Geologist + <br /> Auger O.D. b''2- <br /> Auger I.D. + � <br /> SAMPLING <br /> Holding Temperature �1Oc' •tidaup <br /> Method /C(f C(-fE�"f <br /> Screening Method !✓ ` 7 <br /> V.X ABOVE-GROUND CHR <br /> Tracking Sheet n) COMPLETION <br /> _ COMPLETION <br /> Ground Sudaca <br /> SPOILS <br /> grout <br /> Storage Method_r� tt. <br /> Contamination Noted - ye /no <br /> ft. <br /> Storage Location_ l n. <br /> P <br /> O <br /> SPECIAL PERMIT INFO. <br /> 0 <br /> slotted <br /> Distance to sewer line vection <br /> Domestic well on sitepack <br /> If yes, location & distance -• <br /> f ft. ?t. <br /> GROUTING <br /> MATERIALS USED: <br /> Depth to water I Z Casing type �J <br /> Mix Ratios �ht../E e Blank ft. Screen /S ft. <br /> Installation Method 4-4- Slot size ,9trL <br /> Quantity Installed 'tet Bags cement <br /> Buckets bentonite _ <br /> Bags sand/gravel <br /> Filter Pack type/size 'r3 <br /> Total Billed Time Per Site <br /> Date Permit Finalized <br />