Laserfiche WebLink
MONITORING WELL, INSTALLATION REPORT <br /> Date:�Urap� (1 CONSTRUCTION <br /> Premise Address:3;t 1-1-1den„. ((f,j)61. <br /> Total Depth_ IC) <br /> Well No.:_ MIA )- 1 0 Screen Length (from) tY (to) <br /> Filter Pack (from)_ 53 (to) <br /> Inspector: J�i-, ANC Bentonite (from) <br /> Grout (from) (to) <br /> Permit No. (,3(, ( Drilling rig type <br /> Auger O.D. I.D. <br /> Drilling Company: Completion - Stove pipe/christie box (circle one) <br /> Driller:— INAg1MA0 1 (70 <br /> —�— � casing <br /> Consultant C_(...,,,� _«. <br /> height <br /> Geologist IniA. <br /> ABOVE-GROUND <br /> COMPLETION CNRSTY-BOX <br /> SPECIAL PERMIT INFO - - -- -- - -COMPLETION-, <br /> Ground Surface <br /> Distance to sewer line orocrt <br /> Domestic well on site - (y ) <br /> If yes, location and e - SI h- <br /> � <br /> 'a <br /> = m <br /> R <br /> SAMPLING o vb`f t <br /> Blotted — c �� <br /> Holding TemperatureCnAt �„( secjon <br /> Methodfo�a ate, <br /> Screening Meth <br /> Tracking Sheet - j/y j n ) <br /> SPOILS <br /> Storage Metho �M� MATERIALS/DEVELOPMENT <br /> Contamination nation Noted <br /> Storage Location Casing type_ 2 P1/0. <br /> Blank SS ft. Screen S, h, <br /> GROUTING Slot size_O., p <br /> Bags cement <br /> Depth to water Buckets bentonite <br /> Mix Ratios Bags sand/gravel <br /> Installation Method Filter Pack type/size d (t <br /> Quantity Installed Surge Block: - (y/0 <br /> Discussed with geologist: - (y <br /> EH 29 29 Type of method <br />