Laserfiche WebLink
r <br /> • <br /> MONITORING WELL INSTALLATION REPUAT <br /> Date: CONSTRUCTION <br /> Premise Address: Total Depth <br /> Well No.: Screen Length (from) (to) <br /> Filter Pack (from) (to) <br /> Inspector. Bentonite (from) (to) <br /> Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: <br /> Completion - Stove pipe/cluistie boxbox (c�— <br /> Driller: casing <br /> Consultant - height <br /> � <br /> Geologist T <br /> ABOVE-GrFICUND T <br /> COWLETfON C'HRZTY-SOX <br /> SPECIAL PERMIT INFO. CCiAPLEMN <br /> Crwrd S�rtact <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance <br /> ftft. <br /> _ 0 <br /> SAMPLING <br /> C <br /> 0 <br /> alorad — c <br /> soc cn <br /> Holding Temperature — <br /> Method = yrawtyxt <br /> Screenin;Method <br /> Tracking Shcet - (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 /> GROUTING Bags cement <br /> Depth to water Buckets bentonire <br /> Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> iltstaliadon Method Surge Block: - (y/n ) <br /> Quantity Installed Discussed vAth geologist. - (y/n ) <br /> EH 29 29 Type of method <br />