Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: _ Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist •- <br /> J180YE-GR0UN1D Iry <br /> C�{A35'7Y-BOX <br /> COf, LETfON COMPLETiCN <br /> SPECIAL PERMIT INFO. G'nd Suriacv <br /> Distance to sewer line proms <br /> Domestic well on site - (y/n ) �_ft. <br /> if yes, location and distance - ft <br /> ft. <br /> C <br /> 0 <br /> SAMPLING slotted r <br /> set-�on <br /> Holding Temperature __ <br /> �w gavel Pads <br /> Method <br /> Screening Method _ ? _ <br /> Tracking Sheet (y/n ) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUPING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - ( y/ n ) <br /> Quantity Installed Discussed with geologist: ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />