Laserfiche WebLink
�NITORING WELL INSTALLATION REPO <br /> Date: CONSTRUCTION <br /> Premise Address: el�111_tv,'/rte Total Depth <br /> " Screen Length (from} (to) <br /> Well No.: 2_ Filter Pack (from) (to) <br /> / - Bentonite (from)^ (to) <br /> Inspector � <br /> . . ��/�K S Grout (from) _ice-, <br /> Drilling rig type g57Ay <br /> Permit No._ ��T ✓� _ Auger O.D. `` J.D. Y1` -- <br /> _. Completion - Stove pip chrisffieox ircle one) <br /> Drilling Company:_ <br /> Driller o� ?i Tcasing <br /> / � T height <br /> Consultant �r r '4 <br /> Geologist <br /> i ABOVE-GRCUND <br /> COtvlPI.1:TiON C.iiA1STY-SOX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. �� Ground Suri <br /> Distance to sewer line <br /> Qrout <br /> F <br /> Domestic well on site - (y/ n ) tt. <br /> If yes, location and distance - - ft. . <br /> LL—ft. <br /> �� .V - • <br /> f� <br /> SAMPLINGstored <br /> ' g <br /> j sacycn F,; <br /> Holding Tem a tore <br /> MethoPIS sa* <br /> Screening Method "a" — <br /> Tracking Sheet - IVn ) <br /> .i <br /> r tt- <br /> SPOILS <br /> Storage Method–, <br /> s S MATERIAIS/DEVEI.OPMENT <br /> I <br /> Contamination Noted y/ n ) <br /> Storage Location Casing type Ya AV/, <br /> Blank_ 7" ft. Screen <br /> Slot size , 0-20 <br /> GROUTING Bags cement ' <br /> j 6 Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/siz 60y' ;A'�Z <br /> Installation Method Surge Block: - ( y <br /> Quantity Installed Discussed with geologist: - V n}, <br /> Type of method <br /> EH 29 29 <br />