Laserfiche WebLink
NITORING WELL INSTALLATION!REPOT <br /> Date: CONSTRUCTION <br /> Premise Address: g a nZ ar3ww' Total Depth 5 <br /> Screen Length (from) ' (to)� 22 ; <br /> Well No.: V W ' Filter.Pack !I (from) ` (to),. 2 �_ <br /> Bentonite (from) .d ` -(to)•� a <br /> Inspector. Grout' (from)_ /7' <br /> .Dnll rig type <br /> ;! D <br /> , i .7� - li.D5. lr,( !a•Permit No. Auger, w' <br /> N <br /> 2 5 <br /> Completion Stove pip stie box (circle one) <br />` Drilling Company: <br /> Driller• f�Zl�1� T casing <br /> 3 �'l� ho_ght <br /> Consultant -�•° t <br /> Geologist Lilt � V I {� } g <br /> A8Q1!>r_GACUND CHRtSFY-SOX <br /> COh LET1 id COMPLETION <br /> SPECIAL PERMIT INFO. nd Suriacs <br /> x. grout <br /> Distance to sewer line wi <br /> Domestic well on site A�ce <br /> ) <br /> If yes, location and dis <br /> r <br /> SAMPLING tlored C <br /> ►idcn <br /> Holding Temperature <br /> Methods — 4 <br /> r <br /> Screening Method I <br /> Tracking Sheet - (y/ n) ";E' <br /> ,: a......! ..,it. .. <br /> ft. <br /> SPOILS . . <br /> Storage Method ( J15� MATE Rl&I EVELQPMENT <br /> Contamination Noted - (y/ n } 1 <br /> 1 1� 4It <br /> Storage Location 1J <S T�' Casing type:' 0 � <br /> Blank' 2 ft. Screen 2 b ft. <br /> Slot size I; 0 . OSb <br /> GROUPING Bags Bement LAdu <br /> Buckets bentonite <br /> Depth to water WY _ Bags ,sand/gTavel <br /> Mix Ratios � � Filter,,Pack type/size ggj - j6 9A&j29L od;� <br /> Installation Method 0, GrririVr Lq)) Surge'Block: y/ n ) <br /> E Quantity Installed Discuwith geologist: - (y/ n) <br /> We of method IU fir <br /> EH 29 29 <br /> /©r•,��/ ��./`/ <br /> VU/ �I 'J i <br />