Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: 1 a._1l`( � „ „__....•__•.._._._ CONSTRUCTION <br /> Premise Address:�2LJ_ 32dyy aOA S Total Depth <br /> Screen Length (from) <br /> Well No.: 1V\ W 3 _ Filter Pack (from)_ y 3 _(to) f S r <br /> Bentonite (from) (to) �3 �— <br /> Inspector. t-)j6n2cm ti_ Grout (from) (to)_ H i { _ <br /> Drilling rig type <br /> Permit No. C7 �. 1 C'� _ Auger O.D. Q;.2—`f I.D. <br /> Completion - Stove Pipe/clu-istie box (circle one) <br /> Drilling Company: -f` <br /> Driller: casing <br /> height <br /> Consultant <br /> GeologistTo tnn L1k4A,,;gin <br /> ASOVE-GRCUND G-IRfSTY-30X <br /> COMPLETION coMpc..maev <br /> SPECIAL PERMIT INFO. Ground Skew* <br /> Distance to sewer line Ott <br /> Domestic well on site - (y/n ) ,� ,r , It. <br /> If yes, location and distance - 143 <br /> SAMPLING - o <br /> iOClCrI rA: -� <br /> Holding Temperature C^ <br /> Method gmvw Pack <br /> Screening Method {; — <br /> Tracking Sheet n ) <br /> ft. = --ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - {y/n ) <br /> Storage Location Casing type <br /> Blank_ 4S 111Aft. Screen 90 ft, <br /> Slot size , p ZC <br /> GROUTING Bags cement -%,, 3- <br /> a Buckets bentonite <br /> Depth to water �_ C� Bags sand/gravel <br /> Mix Ratios_ T_ Filter Pack type/size_ <br /> Installation MethodtzNcSurge BIock• - (3/u ) <br /> Quantity Installed Discussed with geologist: - i / n} <br /> EH 29 29 Type of method <br />