Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: S� Sv�5 CONSTRUCTION <br /> Premise Address: Z k-c.1 G J H-L� Total Depth <br /> Screen Length (from) (to) <br /> Well No.: � Filter Pack (from) ' (o (to) <br /> Bentonite (from) cfS (to) <br /> Inspector: 1e v.,h Grout (from)�— (to) _ <br /> Drilling rig type , <br /> Permit No, s,3 gy Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist t^rA .. T <br /> ABOVE-GROUND <br /> COMPLETION CNRIS7Y4= <br /> COMPtETICN <br /> SPECIAL PERMIT INFO. Ground Surface <br /> Distance to sewer line grout <br /> Domestic well on ( y/ n ) <br /> If yes, locatio nd distance - ft. <br /> t' ft, ft. <br /> q <br /> C <br /> SAMPLING = <br /> slotted � <br /> Holding Temperature <br /> Method —" I1yw P� <br /> Screen' ethod <br /> T c gSheet - ( y/ n ) <br /> _.�._ft. IF3 ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contarn ' n Noted - ( y/ n ) <br /> St e Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size %020 <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios 1 y_�'4 � _g�� / 4'�0,,(0(^w Filter Pack type/size _:5 4y <br /> Installation Method--DA A Surge Block: - o/ n ) <br /> Quantity Installed Discussed with geologist: �/ n ) <br /> Type of method_ P9 <br /> EH 29 29 <br />