Laserfiche WebLink
N <br /> 9M MONITORING WELL INSTALLATION REPORT <br /> 9 <br /> 9 <br /> Date: CONSTRUCTION <br /> Premise Address: oLl6� Total Depth <br /> Screen Length (from) (to) <br /> Well No. : Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector. Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/cluistie box (circle one) <br /> Drilling Company: <br /> Driller: —�-- ing <br /> height <br /> Consultant <br /> �yY <br /> �qvGeologist <br /> 1180VE GROUND Ct6iI5TY$OX <br /> COA�LEiION GIXAPLRICN <br /> SPECIAL PERMIT INFO. Ground Sul <br /> Distance to sewer line grout <br /> Domestic well on site - ( y / n ) 7 It, <br /> If yes, location and distance - <br /> . tt. <br /> h. <br /> = c <br /> SAMPLING doCAi <br /> socicn _— <br /> Holding Temperature = ¢avd pads <br /> Method <br /> Screening Method <br /> Tracking Sheet - ( / n ) <br /> y - <br /> ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y / n ) <br /> Storage Location Casing type <br /> Blank ft- Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water � � _ 3 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 />