Laserfiche WebLink
MONITORING WELL INSTALLATION REF 'T <br /> Date: CONSTRUCTION �D <br /> � � `/ i <br /> Premise Address:__ /l 4 �✓� Total Depth o i 10 <br /> Screen Length (from) (to) <br /> Well No.: m�/ Filter Pack (from) (to) <br /> � ttBentonite (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 A <br /> ABOVE-GROUND <br /> COMPLETION CCOMPI.MPI_ -$OX <br /> _cTION <br /> SPECIAL PERMIT INFO. Ground Surface <br /> Distance to sewer line grout <br /> Domestic well on site - ( y/ n ) <br /> If yes, location and distance - <br /> ft. <br /> d <br /> SAMPLING slotted = c <br /> sscton F.' " <br /> Holding Temperature L ;: <br /> Method = VaYW P� <br /> Screening Method <br /> Tracking Sheet - (y/ n ) _ <br /> SPOILS <br /> Storage Method Oy\ MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y/ n ) <br /> b I <br /> Storage Location Casing type PVL�l <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING 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 />