Laserfiche WebLink
1 MONITORING WELL INSTALLATION REPOxf <br /> t � 200 6 <br /> Date : c��- / � CONSTRUCTION <br /> Premise Address : , ��5V Total Depth d� <br /> Screen Length (from) (to) yl <br /> Well No. : es 0< Filter Pack (from) (to) a / <br /> Bentonite (from) C 3 (to) 15' — <br /> Inspector: rout (from) 6 (to) /014— <br /> Drilling rig type <br /> Permit No. ��� Auger O.D. I.D. <br /> C Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: /VI P n 4 <br /> Driller: casing <br /> ` height <br /> Consultant <br /> // v <br /> Geologist � /E" <br /> ABOVE-GAOOND CHAISTY-BOX <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. S <br /> Distance to sewer line 7U I � IDgrout v <br /> Domestic well on site - ( y n a �ij <br /> If yes, location and distance - „ <br /> He <br /> �6 h <br /> weeee <br /> = c <br /> SAMPLING slotted - S <br /> on = <br /> Holding Temperature <br /> / ax6 <br /> vi <br /> Method - _ vel P <br /> ack <br /> Screening Method <br /> Tracking Sheet - 7n ) <br /> �He He <br /> SPOILS <br /> Storage Method rX fLt�+bl� e� l�lA/j MATERIALS/DEVELOPMENT <br /> Contamination Noted - y n ) �� / it <br /> Storage Location_�1� Casing type ` Y <br /> Blank /(9 ft. Screen..-S ft. <br /> Slot size . dZU <br /> GROUTING Bags cement M <br /> Buckets bentonite <br /> Depth to water 7 Bags sand/gravel <br /> Mix Ratios e!ph f 3 Filter Pack type/size <br /> Installation Me ^ Surge Block: - ( y 40 <br /> Quantity Installed 0 ek 'r Discussed with geologist: - ( yCPJI �n <br /> Type of method <br /> EH 29 29 <br /> /� � � Aw� - <br />