Laserfiche WebLink
ONITORING WELL INSTALLATION REPCf w <br /> I <br /> Date: �O CONSTRUCI70N <br /> y o Es lc rarna✓SW , <br /> Premise Address: T�� PCIGI�"l C- of «/H4�h Total Depth <br /> Screen Length (from) �10 (to) -70 <br /> Well No.: µvJq Filter Pack (from) O— (to) 49 <br /> nA + Bentonite (from) gg (to) <br /> Inspector. M Nl2� s Grout (from) S (to) 6 <br /> �2I Drilling rig type w title -(o 13 <br /> Permit No. Auger O.D. I.D. <br /> West�x Completion - Stove pipe/ ' e ox "circle one) <br /> Drilling Company <br /> -TbyW3n1r1^a�mt o- IN [le*- <br /> �'�&. <br /> Driller: -L Docrtf -KatPe` casing <br /> n �" <br /> Consultant I���r`a %NlL t-rlll(ryL5 ��M. height <br /> Geologist Tj)yn Lu Wciln'Ia4 - <br /> Pe lc ✓ Sc� 1u�tvtuvl - Su�erlvt}cv+da' d OCKP�r*ND C RsrY-aox <br /> COMPLEMCN <br /> SPECIAL PERMIT INFO. Gmrd Satan <br /> Distance to sewer line CJD S ml� Grp <br /> Domestic well on site - (yn ft. <br /> If yes, location and distance - 6D ft. <br /> ir. <br /> Cs <br /> Y <br /> O <br /> O <br /> SAMPLING tlonad — <br /> rttusl.UA>Z Mo �/tPuv1A11C sacicn = <br /> Holding Temperature t <br /> Method SIU 14 l(k <br /> Screening Method OtfM r <br /> Tracking Sheet - ( y/ n ) :. <br /> _n. = rr. <br /> SPOILS II , ` ���D <br /> Storage Method 1[lAVOL MATERIALS/DEVELOPMENT <br /> Contamination N � G oted • y/ is vG <br /> Storage Location fl✓1 L Casing type <br /> QJEi1V1I�S fy12Y�S�r' OY� Blank 50 ft. Screen--Z-.L—ft. <br /> Qcro55 Im Slot size • 010 <br /> GROUTING Bags cement_ I <br /> Buckets bentonite I i5aQ <br /> Depth to water Bags sand/gravel / b _ <br /> Mix Ratios Filter Pack type/size <br /> Installation Method 7 h(roJ�P 3 Surge Block: - (y/ t <br /> Quantity Installed ' Discussed with geologist-. - (® n ) <br /> Oj © Type of method <br /> EH 29 29 I jon-5 <br /> 5 4 55 e NOD PSE <br /> 5 � <br /> � �s MW q <br /> Pen> f'j did �o coVtcrrk cut-hn5 <br />