Laserfiche WebLink
MONI'T'ORING WELL INSTALLATION REF--e-r <br /> �6- CONSTRUCTION <br /> Date: <br /> oremise Address: l ( 1 (o- Total Depth <br /> Screen Length (from) (to) 3� <br /> Filter Pack (from) (to) 3 <br /> Well No.: Bentonite (from) ��- <br /> 'j Grout (from) 77- (to)— <br /> inspector <br /> to)inspector. Drilling rig type <br /> Auger O.D. I.D. <br /> Permit No. ;! Completion - Stove Qipe/christie box (circle one) <br /> Drilling Company. ` tl A t.9-k- <br /> 1 casing <br /> Driller. -F- height <br /> Consultant <br /> VV <br /> � <br /> Geo t 1 - JIBCYE-GROUND CHAZT!-30X ' <br /> CO&F ETON C0MPt=„CN <br /> Ground sulacs <br /> SPECIAL PERMIT INFO. <br /> groat Z - <br /> Distance to sewer line �P-'''a '�- , 33,8 <br /> Domestic well on site - ( y/ n ) SQA ”;%�N LA <br /> If yes, location and distance - —_ - <br /> 40 <br /> a <br /> sJottnd -- `a <br /> SAMPLING soc:cn <br /> pack <br /> Holding Temperature v =4 <br /> Method <br /> Screening Method [, <br /> f �` <br /> Tracking Sheet - (y/ n) <br /> SPOILS <br /> MATERIALS/DEVELOP, NT <br /> Storage Method <br /> Contamination Noted - (y/ n) Casing type <br /> Storage Location Blank ft. Screen fr- <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel <br /> Depth to water Filter Pack typesize <br /> Mix Ratios Surge Block: - C y/ n ) <br /> installation Method Discussed with geologist: ' C y/ n) <br /> Quantity Insta/llleJd Type of method <br /> EH 29 29 <br /> �r��I,ctr wn - -Ev la C� en-trJyl� do 01-1 � <br /> , <br /> wn�4l'j�.5 <br /> f-r. -Fom�,L <br /> Co a- P '"� v e � 41r <br /> un-�133.3" Pirhr- hQd , �,�P <br />