Laserfiche WebLink
MONITORING <br /> WELL INSTALLATION REPORT <br /> Date:_ l—12 - 0/Y <br /> CONSTRUCTION <br /> Premise Address:2V3ko yarg e� <br /> Total Depth 5'a <br /> Well No.: /'lett/-!C Screen Length (from)' S-cy (to) $O <br /> s� Filter Pack (from) TO (to) 28 <br /> j Inspector: ✓ /�9. �iy Bentonite' (from) Zg (to) zG <br /> Grout (from) 2 4 (to) <br /> Permit No. Drilling rig type .�i <br /> Auger O.D.- �7 <br /> Drilling Company: Completion- Stove pipe/christie box (circle one) <br /> Driller: ✓eft <br /> ` T casing <br /> Consultant C'RF1 T height <br /> Geologist- &ole �- <br /> ABOVE-GACUND <br /> COMPLETION G4 z7Y-BOX <br /> SPECIAL PERMIT INFO. GCOMPLETION <br /> —�---�� round Surfaco <br /> Distance to sewer line <br /> Domestic wCY/n <br /> ell on site - grout <br /> ) <br /> If yes, location and distance - ZG . ft <br /> 28 ft. <br /> V� m <br /> SAMPLING <br /> 0 <br /> Holding Temperature +mon B <br /> Method " _ P <br /> Screening Method _= _ <br /> Tracking Sheet - (y/n) `�: _ • <br /> SPOILS <br /> Storage Method MATERIAIS/DEVELOPMENT <br /> Contamination Noted - (y/n) - <br /> Storage Location <br /> Casing type 2-1.+ T/r. 4'v I-Imc <br /> Blank ft. Screen 20 ft. <br /> GROUTING Slot size 020 <br /> Bags cement <br /> Depth to water Buckets bentonite <br /> Mix Ratios Bags sand/gravel <br /> Installation Method Filter Pack typesize <br /> Q <br /> Discussed with geologist: - (y/ n) <br /> EH 29 29 Type of method <br />