Laserfiche WebLink
�... lkwd <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: l CONSTRUCTION <br /> I <br /> Premise Address: 3375—: Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> CC e Bentonite (from) (to) <br /> Inspectotc� Se-�" Grout (from) (to) <br /> / Drilling rig type <br /> Permit No. 5C Auger O.D. 21 I.D. <br /> ./ g lc ion - S oinr/rhricrie hoX <br /> Drilling Company: 't"�'s �' <br /> casing <br /> Driller: ' � height \ <br /> Consultant �� L� - <br /> Geologist / r4Ci�✓L� AgpyE GqCUND <br /> CONFL.ETION COMPLETION <br /> COMPLP7ICN <br /> SPECIAL PERMIT INFO. Grcurd S <br /> proof <br /> Distance to sewer line <br /> Domestic well on site - (y 9' ) tt. <br /> If yes, location and distance - ft. <br /> 'M1 C <br /> - 0 <br /> SAMPLING doral <br /> — $ <br /> accicn — <br /> Holding Temperature '/ = gavel past <br /> Method <br /> Screening Method P/ ✓bpi /�/du`�^ <br /> Tracking Sheet - (y/ n ) <br /> s: <br /> ft. = ft. <br /> SPOILS <br /> Storage Method ice. i Irl eve '-5 MATERIALS/DEVEI.OPMENT <br /> Contamination Noted - (y/(11-,) <br /> Storage Location -1ayL i kf �iAv.4.f `- Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water y Bags sand/gravel <br /> Mix Ratios �7 ILL/ 6 G4.s //.-o Filter Pack type/size <br /> Installation Method_ `fn�r_ fa�� Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />