Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date• �� 9c� ONSTRUCTION <br /> Premise Address: Well No. v <br /> Inspector: Total Depth <br /> Green Length y� <br /> ilter Pack -.'5 11 ` _ <br /> entonite Pellets <br /> Permit No. rout <br /> Consultant 3Completion-Stove pipe/ hristie <br /> Geologist eta <br /> Auger O.D. <br /> Auger 1.D. <br /> SAMPLING ---- <br /> Holding Temperature °G • p <br /> Method udT' <br /> Screening Method FAV <br /> RO(LJIND CHRISTY-BOX <br /> Tracking Sheet y n) COWLETION COMPLETION <br /> Ground Surface <br /> SPOILS <br /> /� grout <br /> Storage Method 5 aeiC 2! c <br /> Contamination Noted - e /no • <br /> Storage Location n• <br /> 9 rnn� r:� _ <br /> ID <br /> ID <br /> SPECIAL PERMIT INFO. <br /> _ o <br /> Distance to sewer line sacdoon $ <br /> Domestic well on site - yes, = gr*vW <br /> pack <br /> If yes, location & distance <br /> GROUTING <br /> 14ATERLAILSIUSED*_ <br /> Depth to water ►1 Casing type SC// go ✓r- <br /> - t/ <br /> Mix Ratios : 3 a.,.70% Blank /o ft. ScreenJ�z -ft. <br /> Installation Method Slot size 0, 04'A <br /> Quantity Installed Bags cement_- __�_ <br /> Buckets entonite <br /> Bags /gravely L <br /> Filter Pack type/size 15 MA <br />