Laserfiche WebLink
- MONITORING WELL INSTALLATION REPORT <br /> Date:_ ' I I O S� I CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) <br /> Well No.: INAW -l(� Filter Pack (from)- N 3 ' (to)_ 1 <br /> Inspector._ tnnn<o Bentonite (from)-moi L2 (to)_ t( 3• <br /> Grout (from)— I 9- (to). ZI n <br /> u Drilling rig type <br /> Permit No. I � Auger O.D. I.D. <br /> Drilling Company: IIJ onCCompletion - Stove pipe/christie box (circle one) <br /> ��./ <br /> Driller: casing <br /> height <br /> Consultant__A-N-L `9 <br /> Geologist_ hro Www <br /> A'.OYE-GRCUND <br /> CGhr'LEiION ct R s7Y aoX <br /> SPECIAL PERMIT INFO. G=rd gL,tlky <br /> COMPLEMN <br /> Distance to sewer line prat <br /> Domestic well on site - (y/n ft. <br /> If yes, location and dist <br /> 4/3 ft. <br /> h <br /> V' m <br /> M <br /> C <br /> SAMPLING <br /> so-c 3. ic'c <br /> n <br /> Holding Temperature _ r <br /> Method — <br /> Screenin7 od <br /> •. <br /> Tra g Shcet - (y/ n ) <br /> SPOILS <br /> Storage Method 4-4— C�LtA[a. MATERIALS/DEVELOPMENT <br /> Contamination Noted - <br /> Storage Location 4m!514 o1PO'5e,, Casing type PUC �10L.40 <br /> U Blank_ y_5�_fr• Screen Z8 - <br /> ft-slot size 62--7 <br /> GROUTING Bags cement nJ y <br /> Buckets bentonite Z <br /> Depth to water_ A7 S 2 �' Bags sand/gravel <br /> MiX Ratios Filter Pack type size tl=i M—A 1— <br /> -iAstallation Method +k .,( Surge Block: - n ) <br /> Quantity Installed Discussed with geologist. - (y/n ) <br /> Type of method <br /> EH 29 29. � _ ' <br />