Laserfiche WebLink
v MONITORING WELL INSTALLATIONTtEPORT <br /> Date:_ (y clt�o n CONSTRUCTION <br /> Premise Address:-309 l�rr nr koc.�.�a„ -CA Total Depth_ <br /> .L I Screen Length (from)_ <br /> Well No.: _ Filter Pack <br /> (from) ��c'1 (to) <br /> Inspector: 0�&V.. Ab\L0 V�^ Bentonite (from)_&'f (to) <br /> Grout (from) (to)Y� <br /> C� � I.D.Permit No. Drilling rig typ <br /> Auger O.D. 6�--2- LD. <br /> 1 <br /> Drilling Company: ,n f a► b1�V Completion- Stove pipe/chnstie box (circle one) <br /> �` � � /y-n <br /> Driller: 7TU&-V%' '� e�C� casing <br /> nt /�! Jt ,eel height <br /> Consulta <br /> GeoFn��rohman� <br /> Geologist <br /> ABOVE-GROUND <br /> CONPLET}ON C_HRZTY-BO <br /> SPECIAL PERMIT INFO. COMP <br /> Ground Surfaces <br /> Distance to sewer line <br /> Domestic well on site - (y/ <br /> If yes, location and distance ft. <br /> ftft. <br /> e - <br /> = m <br /> SAMPLING — o <br /> Flo ttad — c <br /> ixtion _ .$ <br /> Holding Tem erature Z = <br /> Method_ aC_V-'w . = VAYW pxx <br /> Screening Method <br /> Tracking Sheet - y n) " <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Note - in <br /> Storage Location C G k -r e_- ` Casing type Z�� $ak l) e <br /> Blank 0- O ft. Screeny ' (.2. ft. <br /> Slot size_ 0 <br /> GROUTING Bags cement <br /> Buckets bentonite_ Z <br /> Depth to water�`l Bags sand/gravel _ 1 <br /> Mix Ratios_- Filter Pack type/size <br /> Installation Method }r�._.w;� T 1 Surge.Block:=_(.y_/ <br /> - ------ ----- <br /> Quantity Installed Discussed with geo ogist: n) <br /> EH 29 29 Type of method <br />