Laserfiche WebLink
orONITORING WELL INSTALLATION REPT <br /> Date: q//IM CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) / (to) <br /> Well No.: ,�'' D 7/ tel)"Z YJ ( Filter Pack (from) 1 (to)� <br /> i o / Bentonite (from) ( (to) 3 <br /> Inspector: Grout (from) 3 (to) <br /> Drilling rig type l•� S <br /> Permit No. Auger O.D. V(11 I.D. z <br /> Com on - Sto ipe/christie box (circle one) <br /> Drilling Company: ,` ,, <br /> Driller: I �'�^'` TT cas I q <br /> height <br /> Consultant / _qV7F <br /> Geologist (�lL-✓� •- <br /> VE-GROU CHRZ Y-BOX <br /> N COMPLETION <br /> SPECIAL PERMIT INFO. Ground Sumacs <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) <br /> ft. <br /> If yes, location and distance - <br /> e <br /> = c <br /> SAMPLING slotted = c <br /> section <br /> Holding Temperaturegravol_ P <br /> ack <br /> Method <br /> Screening Method <br /> Tracking Sheet - ( y/ n) _ <br /> _. .ft. ft. <br /> SPOILS to 16- <br /> Storage <br /> 6- <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type � l�dL/ <br /> Blank ft. Screen / ft. <br /> Slot size 0.610 <br /> GROUTING Bags cement <br /> .�/ Buckets bentonite ZS" <br /> Depth to water Bags sand/gravel ? <br /> Mix Ratios A--t Filter Pack type/size �-/!z <br /> Installation Method Surge Block: - (y/(n)) <br /> Quantity Installed_ Discussed with geologist: - n ) <br /> Type of method <br /> EH 29 29 <br />