Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: CONSTRUCTf ON <br /> Premise Address.- Total Depth <br /> Screen Length (from) <br /> Well No.: Filter Pack (from) (to) <br /> Inspector. Bentbnite (from) (to) <br /> .. Grout (from) --- <br /> Grout <br /> Drilling rig type ~r <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company; <br /> Completion - Stove pipe/chrisde box (circle one) <br /> Drfller: casing <br /> he;ght <br /> .Consultant - <br /> Geologist , <br /> A°C E-GACUND <br /> COMPLETION Q-SSM_aox <br /> SPECIAL PERMIT INFO. C.OmPu IGN <br /> Cirourd SLsiaca <br /> Distance to sewer line yroct <br /> Domestic well on site - (y/n) <br /> If yes, location and distance - (t. <br /> .SAMPLING — <br /> �IarAi <br /> i4CICf1 ;.. �7 <br /> Holding Temperature <br /> Method __ Qrxwl pa3* <br /> Screening Method tri <br /> Tracking Sheet - {y/ n ) . -= <br /> . a <br /> _ <br /> y r • y <br /> SPOILS <br /> Storage Method MATERIALS EWLOPMENT <br /> Contamination Noted - {y/n) <br /> Storage Location Casing type <br /> BIank ft. Screen ft. <br /> Slot size <br /> GROtMNG Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel.-. <br /> Mik Ratios Filter Pack typesize <br /> 4pstallation Method Surge Block: - (y/n) <br /> Quantity installed Discussed with geologist: - (y/n} <br /> Type of method <br /> EH 29 29. . <br />