Laserfiche WebLink
MONITORING WELL INSTALLATION REP64 <br /> Date: CONSTRUCTION <br /> Premise Address: 6 D S, Cj—"( Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion- Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller- casing <br /> height <br /> Consultant T <br /> Geologist �- T <br /> ABOVE-GROUND CHR�M-BOX <br /> OOWPL ETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surlacs <br /> Distance to sewer line <br /> Qtout <br /> Domestic well on site - (y/n) ft. <br /> Ifyes, location and distance - . <br /> ft. <br /> SAMPLING slotted <br /> & cdon _ <br /> Holding Temperature <br /> Method f — liI�Pack <br /> Screening Method <br /> Tracking Sheet - (y/n ) ° <br /> � v <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter pack type/size <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/n ) <br /> Type of method <br /> EH 29 29 <br />