Laserfiche WebLink
I `► <br /> MONITORING WELL INSTALLATION REF-.re-T Toe C�(- <br /> bO r 0�-V <br /> 2 � -to - <br /> 00 � a )Vl.ewl � ov r t .i. ��4? <br /> 2U 2� o- �° CONSTRUCTION To(g <br /> Date: // / f '� <br /> 2 7: J �1 �r- Tonal Depth 1� V f'�t� {- t,Xi <br /> ?remise Address: 3 Seen Length (from) 1 S`U, (to) W"11- <br /> ?- remise <br /> Filter hack (from) t 6 (to) o <br /> Well No.: S b 1 I Benronire (from) f +-Z (ro) 1 `ill o w <br /> .Grout (from) —(to)�--fi'~'o <br /> inspector: S •Drilling rig type <br /> S Auger O.D. 41 <br /> Permit No. [ + ( ! Completion - Stove pipe/christie box (circle one) c(5 ) <br /> I I Drilling Company. I l �D��i K-9- C w�d K�f�r C.S-, <br /> 1 g j, i-t '�j ,'A-1 L <br /> Driller. + 7– 'esghL �i S C k v r P e <br /> Consultant <br /> Geologist o 14�AjCV=--"i:lOUNO p-Rt5"Y-3aX <br /> Oct !EMCN Compt=��CN <br /> SPECIAL PERMIT INFO. <br /> id�� groat <br /> Distance to sewer line <br /> Domestic well on site - ( y/ n ) <br /> if yes, location and distance - <br /> e <br /> ook,-@ (Z- -4o( <br /> SAMPLING csc"A soc-:;n <br /> / — 71voi Pack <br /> Holding Temperature <br /> Method " _ <br /> Screening Method n <br /> Tracking Sheer - (y 1 n) <br /> � 2 <br /> SPOI C <br /> (A//N\u 1N1 S MAT ERIALS/DEVELOPIVIENT K <br /> Storage Idiethod �1 D e v� , r <br /> Contamination Noted 7-OFF ) D+" k`-'t V — <br /> �i-ti. Ci/�° Casing type Z S fG <br /> Storage Location - �r � Blank 1 '1 fn Sa-een <br /> Slot size d cement r <br /> GROUTING Bags ce <br /> Buckets bentonite <br /> Bags sand/gravel <br /> Depth to water / , ) Filter Pack type/ ' e <br /> Mix Ratios "�/ Surge Block: - / n) ' <br /> Installation MethoDiscussed with ;0109isr-{ - 3� <br /> Quantity Installed ' ( Type of method=( /� <br /> EH 29 29 <br />