Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: 1 CONSTRUCTION <br /> Premise Address: I l �S 3 ' Total Depth <br /> ' I , Screen Length (from) 30 (to) /d <br /> Well No.: W Filter Pack (from) 7 T—(to) 71 <br /> Bentonite (from) (to) <br /> Inspector: Grout (from a (to) <br /> ` Drilling rig type <br /> Permit No. 7J \ Auger O.D. �3 I.D. <br /> Completion -Stove pipe/cluisde box (circle one) <br /> Drilling Company: <br /> �f�e�__ .vri <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist�� A80VE GFCUND <br /> COWLEfION CON <br /> COOMPLETIMPLEnON <br /> SPECIAL PERMIT INFO. Ground Surtan <br /> proof <br /> Distance to sewer line <br /> Domestic well on site - (y/ n ) �-• ft. <br /> If yes, location and distance - ft. <br /> .lift. <br /> a <br /> = o <br /> SAMPLING sloped <br /> aaden 44 <br /> Holding Temperature _ gravel past <br /> Method <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) . <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Note • (y fr p <br /> Storage Location Casing type �)' l <br /> Blank, 07 fr. Screen L ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite / <br /> Depth to water �'� Bags sand/gravel <br /> Mix Ratios _ Filter Pack type tze <br /> Installation Method Surge Block: y n ) <br /> Quantity Installed Discussed with geologist•. • (y/ n ) <br /> Type of method <br /> EH 29 29 <br />