Laserfiche WebLink
*0NITORING WELL INSTALLATION REPO <br /> Date: �?I3I cl 3 CONSTRUCTION <br /> Premise Address: 0 I Md- ^^^`"'�"` Total Depth <br /> S3 �� Screen Length (from) (to) <br /> Well No.: ! i Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector. Grout (from) �T)(to)S <br /> C3 Drilling rigtype 3S <br /> Permit No. ( ?"y��3 Auger O.D. 9' I.D. (7'/1 <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company <br /> Driller: casing <br /> Consultant <br /> �-+� iheight <br /> 0. s <br /> Geologist ( <br /> ABOVE-GRCUND CHR*rY-BOX <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Sufacy <br /> Distance to sewer line Q(out <br /> Domestic well on site - (y On -'-ft. <br /> If yes, location and distance - n, <br /> ft. <br /> 'N.. �. <br /> -P �- <br /> .K <br /> � Q <br /> SAMPLING .bra.J <br /> soCion <br /> Holding Tem erature <br /> Method A ` <br /> Screening Method <br /> Tracking Sheet / n ) <br /> SPOILS / <br /> Storage Method / 4�u/ e� MATERIALS/DEVELOPMENT <br /> Contamination Noted - p ) <br /> Storage Location Casing type syl/1 <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> ,i Buckets bentonite <br /> Depth to water C ' S� Bags sand/gravel <br /> Mix Ratios A Awf C 13 Filter Pack type/size <br /> Installation Method tU4,,....ti Surge Block: - (y/ n ) <br /> Quantity Installed ;Zqj s Discussed with geologist: - ( y/ n) <br /> Type of method <br /> EH 29 29 Ok <br /> (3dgo <br />