Laserfiche WebLink
MONITORING WELL INSTALLATION REPORf' <br /> Date: CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) _(to} <br /> Well No.: Filter pack (from) lo57 (to) qT <br /> Bentonite (from) q-� - (to) J <br /> Inspector: Grout (fro ) 57 (to) <br /> Drilling rig type P'T- ('.w1. -1 5 <br /> Permit No, Auger O.D. L C.D. 7 <br /> Completion - Stove pipe/cliristie box (circle one) <br /> Drilling Company:p <br /> Driller- caslnq �\ <br /> height <br /> ConsultantPTA <br /> 4N r' ' <br /> Geologist — <br /> T <br /> ABCVE-GRCUND G�FitSTY-30X <br /> C0141�1.,.�TiOi`d �` COhiPL�CN <br /> SPECIAL PERMIT INFO. 3=nd Sulwo <br /> Distance to sewer line <br /> Ott <br /> Domestic well on site - ( y/ n } 3 7 - ft. <br /> If yes, location and distance - ) �- <br /> — m <br /> w <br /> - C <br /> Q <br /> SAMPLING 510ro <br /> aQc'icn � <br /> Holding Temperature <br /> Method Ravel <br /> Screening Method 'c= <br /> Tracki ig Sheet - { y/ n ) — <br /> ts. <br /> SPOILS <br /> Storage Method MATERIALS/DEVEI.OPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <7 r�Pdc� L16 <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water7 Bags sand/gravcl <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - ( y/ ii ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EIS 29 29 <br />