Laserfiche WebLink
MONITORING WELL INSTALLATION REP^RT <br /> SSA <br /> Date:--J? CONSTRUCTION <br /> Premise Address: Total Depth <br /> Screen Length (from) (to) <br /> Well No.: - f Filter Pack (from) (to) <br /> Bentonite (from (to) <br /> Inspector: Grout (fro ) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: <br /> 1A Completion - Stone pipe/christie box (circle one) <br /> Driller: N�.4 casing <br /> height <br /> Consultant dLt-.-�•-- <br /> Geologist -- <br /> ABOVE-GROUND <br /> CONFLETION Ct{AiSiY-80X <br /> / COMPLEnON <br /> SPECIAL PERMIT INFO. Ground Surtsct <br /> Distance to sewer line <br /> grout <br /> Domestic well on site - ( y/ n ) 1 tt <br /> If yes, location and distance - <br /> tt. <br /> tt. <br /> _ o <br /> SAMPLING <br /> slotted c <br /> aocaon <br /> Holding Temperature <br /> Method = P <br /> ack <br /> Screening Method ' <br /> Tracking Sheet - ( y/ n ) _ <br /> tt. = tt. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y/ n ) /f <br /> Storage Location Casing type <br /> Blank ft. Sc en U <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water (v Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - ( y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />