Laserfiche WebLink
V.,,{ONITORING WELL INSTALLATION REN.AT <br /> T� lb2- -- <br /> Date: CONSTRUCTION <br /> Premise Address:. "1�?' Total Depth <br /> Screen Length (from) S U (to) <br /> Well No.: w ' J Filter Pack (from)_ 5o -(to) 'j <br /> Bentonite (from) _ ] 1 {to) 7 <br /> Inspector. C c Grout (from) SSS (to) �, <br /> Drilling rig type <br /> Permit No. <br /> � y 1. ..,.,1. 7,1 Auger O.D. I.D. <br /> Drilling Company: S ')�C+Vl.-__� <br /> Completion - Stove pipe/chri.stie box (circle one) <br /> Driller: 00'_� casing <br /> � � � � height <br /> COnSUIianC �-� � 4 V <br /> Geologist <br /> ABCVE-GrrqC(JND <br /> MkPLETfON �*Ty <br /> SPECIAL PERMIT INFO. CN <br /> Ground Su fact <br /> Distance to sewer line Grout <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - <br /> — o <br /> 0 <br /> S ANG - r <br /> tloro,� c <br /> HoIdin =oc�cn — <br /> g Temperature <br /> Method <br /> V"Vst P-u* <br /> Screening Method <br /> Tracking Shcet - (y/ ri <br /> SPOILS ft. <br /> Storage Method_ 61, S <br /> Contamination Noted - MATERIALS EVELOPMENT <br /> (y/n ) <br /> Storage Location <br /> Casing type �VG <br /> Blank ft. Screen 15 ft. <br /> GR0 NG Slot size <br /> Bags cement <br /> Depth to water "" �1 Puckers bentonite <br /> Mix Ratios Bags sand/gravel <br /> Installadon Method Filter Pack type/size <br /> Quantity Installed Surge Block: - (y/ n ) <br /> Discussed with geologist: - (y/ n) <br /> EH 29 29 Type of method <br />