Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> l <br /> Date: l l f <br /> CONS OI l <br /> Premise Address;� <br /> Total Depth <br /> Well No.; 1^) _ Screen Len <br /> gth (from)_ 4 (to) S <br /> Filter Pack (from)_ q ; (to) <br /> Inspector. Bentonire (from) n. 3 <br /> �— Grout (from)'(to) <br /> Permit No._ HVz.wo y0 Z / Drilling rig type —`— (to)=yQ_ <br /> Auger O.D. <br /> Drilling Company Completion- Stove i <br /> P P uistie box (circle one) <br /> Driller. <br /> casing <br /> Consultant <br /> ATJC /-IV, he_ght <br /> Geologist <br /> ABCVE-GACUND <br /> SPECIAL, PERMT INFO. CO&PLL`TION Ct+A;m-Box <br /> . <br /> Distance to sewCru:rG Safra N <br /> sewer line i, <br /> Domestic well on <br /> If yes, loci /n ) <br /> grout <br /> ationan ste <br /> - <br /> et� <br /> _ a <br /> SAMPLINGHolding <br /> MethodTemperature t sloe _ ,g <br /> Screening Methodl /) �— = pavdyaclt <br /> Tracking Shcet n _ <br /> SPOILS �'� <br /> SC <br /> Storage Method_r�^ <br /> Contamination Noted <br /> Storage Location (y MATERI <br /> ) s/p�OpMENT <br /> Casing type <br /> 7 GIJh <br /> GROVD,NG lar[ * S {r Screen <br /> Ss �Zs fr <br /> Slot size p Zp <br /> Depth to water iv Bags cement <br /> Mix Ratios / Buckets bentonite <br /> Installation y - r Bags sand/gravel <br /> Method a0 Filter Pack <br /> QuantityInstalled :14 type/size <br /> Surge IIlock -�y)j n ) <br /> EH 29 29 Discussed with geologist - <br /> Type of method (y <br /> _ J <br />