Laserfiche WebLink
i,.,IONITORING WELL INSTALLATION REPt-o f <br /> Date: 7�II T I��I '' II CONSTRUCTION <br /> Premise Address: p 10 ( ✓ Total Depth <br /> Screen Length (from) (to) <br /> Well No.: 2' Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from)-(to)- <br /> Drilling <br /> from) (to)Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: cas i.nq <br /> height <br /> 7-m� <br /> Consultant L� <br /> —QW7:F <br /> Geologist be <br /> ABOVE-GROUND CXRZ7Y4= <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. G=nd Su1'n <br /> proal <br /> Distance to sewer line <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - ft, <br /> - ft. <br /> _ <br /> = c <br /> c <br /> SAMPLING •bn = 8 <br /> a�c4on <br /> Holding Temperature gnwl parse <br /> Method <br /> Screening Method ' <br /> Tracking Sheet - ( y/ n ) _ <br /> fL = n. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft. Screen h. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bagssand/ <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 />