Laserfiche WebLink
64 <br /> `r Nr rORING VELI.INSTALI ATION.REP <br /> (D <br /> Date: <br /> Premise Address: • 6 ZS W v eL-AA Total Depth 3 I2 <br /> Screen Length (from) ' (to} <br /> Well No.: MW Filter Pack (from) (to) Z <br /> Benconite (from} (to) <br /> Inspector: S i Grout (from) (to}____,..__ <br /> Drilling rig type <br /> Permit No.--22,-25MJ, Auger O.D. I.D. <br /> nKC Yom► Completion- Stove pipe/christie box (circle one) <br /> Drilling Company:, - <br /> Driller: Seel 5teTkOn *I- oasinq <br /> +.+ect Vk" Leo ra•+� W-�- <br /> height <br /> Consultant - -�� —W <br /> Geologist Din - S L <br /> ABOVE4RO= CHR*W4= <br /> COMIPLMN COMIPLMION <br /> SPECIAL PERMIT INFO. QMUed Swfaa <br /> Distance to sewer line <br /> Domestic well on site - (y/ a� '-B, No <br /> If yes, location and distance • <br /> � ft. 2 <br /> . = a <br /> AS MPL NGl 810tsd 3 <br /> so�cn <br /> Holding Temperatwre <br /> Method P <br /> Screening <br /> "tracking Sheet - E y/n <br /> S€�OIIS <br /> Storage Method L-)W 5 M&,TERIALS/DEVELOPMENT <br /> Contamination Noted- y n} <br /> Storage Location - casing type, _ <br /> Blank ft. Screen ft. <br /> Slot size <br /> Bags cement <br /> 2 Buckets bentonite <br /> Depth to water„ Bags sand/gravel <br /> Mix Ratio: Filter Pack typesize <br /> Installation Method Surge Block: - (y/ n) <br /> Quantity Installed Discussed with geologist: - (y/n} <br /> Type of method <br /> EH 29 29 <br />