Laserfiche WebLink
gONITORING WELL INSTALLATION REPOAT <br /> Date: 7 1 CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) (to) t <br /> Well No.: L-M 127 k Filter Pack (from) T7 (to) 7,-1. <br /> °°pp Benronite (from) 2-Z (to) " <br /> Inspector: a> v �rwtt Grout (from) 2,0 (to) I`> <br /> Drilling rigTy <br /> -e <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: <br /> Completion - Stove pipe/christie box (circle one) <br /> � <br /> Driller: casin <br /> n <br /> he-4g <br /> Consultant IMKW\. C <br /> Geologist &M � � _ T <br /> ABOVE-GROUND <br /> OOWLETION CF4izry BOX <br /> C N <br /> SPECIAL PERMIT INFO. Grourd SLexy <br /> Distance to sewer line grout <br /> Domestic well on site - ( y/ n ) <br /> If yes, location and distance - <br /> a <br /> = m <br /> a <br /> — o <br /> — C <br /> SAMPLING <br /> Toned = <br /> tecicn <br /> Holding Temperature _ 9"vd G <br /> ack <br /> Method — <br /> Screening Method <br /> Tracking Sheet - Cy/ n ) <br /> 1t. <br /> SPOILS <br /> Storage Methods - MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Locationbt-C�C, Casing type g"�dL SIA U <br /> Blank J� ft. Screen SS `b ft. <br /> GROUTING Slot size�,D� <br /> Bags cement <br /> Buckets bentonite <br /> Depth [o water _ Bags sand/gravel d. to(led <br /> Mix Ratios ? Filter Pack type/�3 <br /> Installation Method Surge Block: - (�y/ n ) <br /> Quantity Installed Discussed with geologist: • y,/ n ) <br /> Type of method <br /> EH 29 29 <br /> I <br />