Laserfiche WebLink
err ,.,wr <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: 7 <br /> CONSTRUCTION <br /> r <br /> Premise Address: fooUjC��, �� S�- ��� Total Depth <br /> S4"` �' '� Qq <br /> Screen Length (from)' l <br /> Well No.: 1ti• _ "� d`f f S Filter Pack (from) 10 (to) ';Z _ <br /> J a Bentonite' (from) (to) G <br /> Inspector: _ y o0lC�ewl Grout (from) O' (to) <br /> Permit No. S 9410 l04 U <br /> Drilling rig type <br /> Auger O.D. I.D. <br /> Completion- Stove pipe/christie box (circle one) <br /> Drilling Company:_ ct D 6 1 k <br /> ° �Driller: <br /> casing <br /> height <br /> Consultant <br /> Geologist_ V 2 r '44 T <br /> .ABOVE-GROUND <br /> CON?LEf10N CHRZTY-Sox <br /> SPECIAL PERMIT INFO. COMPLE'f70N <br /> C�ra.md Surface <br /> Distance to sewer line grout p <br /> Domestic well on site - (y/n) <br /> If yes, location and distance - h. <br /> SAMPLING — o <br /> ' ebttad •? — c <br /> • - sac�on = � <br /> Holding Temperature _— <br /> Method <br /> Screening Method <br /> Tracking Sheet - (y/n) <br /> :r = a7° <br /> n. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location Casing type f(z# yo CVC <br /> Blank 12 ft. Screen r S— ft. <br /> Slot size 0- 0)0 " <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method __•__.___-- o <br /> Quantity Installed Discussed with geologist: - (y/n ) <br /> EH 29 29 Type of method <br />