Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: 7{� CONSTRUCTION <br /> Premise Address: lU, &(PP&0qAPa- Kc7 Total Depth (20 <br /> Well No.; k;-2- Screen Length (from)4W <br /> Filter Pack (from) f z ' (to) Iy _ <br /> Inspector: `� Cl�Ck�I Bentonite (from) (U$' (to) 1,25 <br /> Grout (from) (085 (to) 0 ' <br /> Drilling rig type Grv%IF1 _g S <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company:_`(k pPe D;-;1Gvkc, Completion - Stave pipe/christie box (circle one) <br /> Driller: Torte casing <br /> height <br /> Consultant Tt., <br /> Geologist. Jue 1G 20 <br /> ABOVEGROUND <br /> OUMPLETION ONRZT-Y-BOX <br /> SPECIAL PERMIT INFO. COMPLETION <br /> -----� fdround SuAace <br /> Distance to sewer line p�W{ <br /> Domestic well on site - (y/n ) <br /> If yes, location and distance - It580 los ft. <br /> n. <br /> m <br /> F <br /> O <br /> SAMPLING — `o <br /> . slotted — c <br /> m <br /> tocton <br /> Holding Temperature <br /> Method 9R�Pte* <br /> Screening Method <br /> Tracking Sheet • (y/n) _ <br /> h. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) <br /> Storage Location Casing typeTppcg OorNa cQ Ct.ea- <br /> Blank 117 ft. Screen ft. <br /> Slot size 0,cAO <br /> GROUTING Bags cement <br /> Buckets bentonite 1 '1-2- <br /> Depth <br /> /2Depth to water Bags sand/gravel61 <br /> Mix Ratios Filter Pack type/size zliz sa d1 <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - (y/n) <br /> Type of method <br /> EH 29 29 <br />