Laserfiche WebLink
MONITORING WELL INSTALLATION•ORT <br /> Date: /`l 3 CONSTRUCTION <br /> Premise Address:_ 15r_"-cct Cek5r 2 3U r'vA'3rR1q_ Total Depth <br /> Well No.: - J�� Screen Length (from) 10-5- (to) Ir <br /> Filter Pack (from) /0 3 (to) NS <br /> J , yo n Bentonite' (from) /L'i (to) 16"57 <br /> Inspector: Grout (from) 0,5- (to) /01 <br /> Permit No. SkL)o 2y y <br /> �/ Drilling rig type C ME r / ,-A— <br /> Auger <br /> AAuger O.D. " I.D. 1,2.5 <br /> Drilling Company: <br /> Completion- Stove pipe/christie box (circle one) <br /> C����� <br /> Driller: <br /> casing <br /> ✓ <br /> Consultant EL' height <br /> Geologist M6gt( /U. P)"C} w <br /> ABOVE-GROUND <br /> CONPLEf{ON GHAISTY-80X <br /> SPECIAL PERMIT INFO, COMPLETION <br /> 6rcund Surlxe <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n) /v/ <br /> If yes, location and distance - ' ft. <br /> /p� <br /> n. /03 ft. <br /> R <br /> b <br /> r <br /> SAMPLING — o <br /> Blotted — c <br /> Holding Temperature — <br /> Method "VW P� <br /> Screening Method <br /> Tracking Sheet - (y/n) <br /> SPOILS V <br /> Storage Method NUPFER <br /> MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/3()i) <br /> Storage Location Casing type 2 / y( / C <br /> Blank ft. Screen /O ft. <br /> Slot size C.C 217 <br /> GROUITNG Bags cement_ lick <br /> Buckets bentonite_ <br /> Depth to water Bags sand/gravel_ O'bwf <br /> Mix Ratios Filter Pack type/size 4 <br /> Installation Method Surge Block:,-_(Y/_n_)_ <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> EH 29 29 <br /> Type of method <br /> ' <br />