Laserfiche WebLink
MONITORING WELL INSTALLATION REP* <br /> Date: (o I I�1 n1 CONSTRUCTION <br /> Premise Address: O 1 VL Cl(.14 ", Total Depth �S <br /> n Screen Length (from) tn' (to) 30 <br /> Well No.: 11��' Filter Pack (from) 31 (to) zS' <br /> Ins �AAM_�a Bentonite (from) t ` (to) X' <br /> Inspector. i <br /> P ` Grout (from) ( (to) 6 <br /> Drilling rig type <br /> Permit No. C� �I _, �,� Auger O.D. to V.g " I.D. <br /> Completion- Stove pipe/christie box (circle one) <br /> Drilling Company- ��Pr�- [M� ' <br /> Driller: �Z I sic casing <br /> height <br /> Consultant -� <br /> Geologist ll rn v �� nPn T <br /> 1t80VE GROUND <br /> COMPLETK)N CF6iISTY43OX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Sv}� <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - n <br /> eft. tt. <br /> _ <br /> — c <br /> SAMPLING = —° <br /> slotted — C <br /> sacdon = <br /> Holding Temperature <br /> Method — 9sV49 Pack <br /> Screening Me <br /> Trackin eet - (y/ n ) _ <br /> '0 <br /> SPOILS <br /> Storage Method cn, rvtcni!r ' MATERIALS/DEVELOPMENT <br /> Contamination Noted- (y/(V) '-( <br /> Storage Location Casingtypelo' HC- f-j LAI z,0'.-i4,.w(.rA�SLC-f <br /> Blank t o fc. Screen n fr. <br /> Slot size n s o <br /> GROUTING Bags cement 'zi <br /> Buckets bentonite—j (u� <br /> Depth to water Bags sand/gravel I N• t <br /> Mix Ratios Filter Pack type/size -#3 In&..cs ton s01,-r.P <br /> Installation Method Surge Block: - (Q/ n ) <br /> Quantity Installed nJ z(9 can 110 7 Discussed with geologist: - ((J)/ n ) <br /> Type of method Unc1 . <br /> EH 29 29 <br />