Laserfiche WebLink
./ OF_�L_ <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: P1 CONSTRUCTION <br /> Premise Address: 0 ( Well No. W <br /> Inspector• Total Depth _ <br /> Gj Screen Length <br /> Filter Pack 4 <br /> /} Bentonite Pellets <br /> Permit No. Grout /a <br /> Consultant Completion-Stove pip christi.e box <br /> GeologistT <br /> Auger O.D. <br /> Auger I.D. <br /> SAMPLING — - <br /> Holding Temperature °G <br /> stick-up <br /> Method_ <br /> Screening Method <br /> ABOVE-GROUND CHR ISTY-BOX <br /> Tracking Sheet 0n) COMPLETION <br /> COMPLETION <br /> Ground Surtac9 <br /> SPOILS <br /> grout <br /> Storage Method <br /> Contamination Noted - y�ea�no j. W <br /> Storage Location ft' <br /> m <br /> 0 <br /> SPECIAL PERMIT INFO. <br /> c <br /> slonsd <br /> Distance to sewer line 1>161D section <br /> Domestic well on site -&D/no gravel pa(* <br /> If yes, 1 cation & distance - <br /> Am r--- <br /> GROUTING <br /> MATERIALS USED: <br /> 1 ` <br /> Depth to water U Casing type � <br /> Mix Ratios Blank // _ ft. screenft. <br /> Installation Method Slot size d. b/D <br /> Quantity Installed Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel <br /> Filter Pack type/size <br /> If <br /> Total Billed Time Per Site <br /> Date Permit Finalized <br />