Laserfiche WebLink
-,IONITORING WELL INSTALLATION REPG. <br /> Date : 31 Zplo CONSTRUCTION � <br /> Premise Address:: 2lOq M 9 �u/� a� [ <br /> Total Depth / 9 <br /> Screen Length (from) (to) <br /> Well No.: C � Filter Pack (from) (to) J <br /> Bentonite (from) 37 (to) . <br /> Inspector: a Grout (from) 35 (to) <br /> �jp p 2 Drilling rig type 64" 6 1q5 <br /> Permit No. G / �j Auger O.D. 15 " 19V I.D. 9" 2 �V <br /> CompletionStoVe pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: ��'�� �'/ "r 7 casing <br /> iK height <br /> _ Consultant (, � <br /> Geologist `� "� fL -- T <br /> ABOVE-GROUND r CNAiSTY-BOX COMPLETION OMPLEMCN <br /> SPECIAL PERMIT INFO. I nd SUrf <br /> Distance to sewer line orout <br /> Domestic well on site - ( y ri �i413 ___ cc <br /> ft. <br /> If yes, location and distance - �G,x uroovl ewe <br /> ft <br /> �ft. Sewell <br /> C- o <br /> SAMPLING stoned = ' B <br /> ucton <br /> Holding Temperature G// <br /> 7xvig pack <br /> Method = <br /> Screening Method <br /> Tracking Sheet - ( y / n ) <br /> 41 <br /> SPOILS <br /> Storage Method S� // � O MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y / n ) <br /> Storage Location Q Casing type <br /> Blank 3 ft. Screen <br /> Slot size <br /> GROUTING wags cement Lts U IW II I 101,E <br /> Buckets bentonite P2 0 o <br /> Depth to water = 3 Bags sand/gravel <br /> Mix Ratios c3 t 1" Filter Pack type/size l— <br /> Installation Method Surge Block: - ( y / n <br /> Quantity Installed SS -r SS ! tl Discussed with ge gist: <br /> Type of method <br /> EH 29 29 <br />