Laserfiche WebLink
`-�TORING WELL INSTALLATION REPC,�— <br /> Date:_ 4 9 4 CONSTRUCTION <br /> r <br /> Premise Address: �O`J� M Flt, Total Depth /7 <br /> Screen Length (from) /!o.G (to) 7.5 <br /> Well No.: HO - Filter Pack (from) !-7 (to) <br /> Bentonite (from) 6�1 (to) <br /> Inspector. GC'4rje5Grout (from) S (to) .®— <br /> Drilling rig type C44 65 ' <br /> Permit No. _ 2 ) - /77() Auger O.D. .2. <br /> Completion - Stove pipecluis 'e bo (circle one) <br /> Drilling Company: ��-Tn-�*'1 <br /> Driller: �lDgz�' casing <br /> n <br /> Consultant 'LN wla"65 T height <br /> Geologist �� 5LU <br /> ABOVE-GROUND CHRZ Y-Sox <br /> COMPLETION COMPLEMON <br /> SPECIAL PERMIT INFO. Ground Surfece <br /> Distance to sewer line <br /> �J p grout <br /> Domestic well on site - ( y/ .�`:,ft. <br /> If yes, location and distance - ft. <br /> ft. <br /> O <br /> SAMPLING alone i <br /> aodcn M — <br /> Holding Temperature 9�C" - 9M,,, Pack <br /> a — <br /> Method )U.tt lx' /GC-' <br /> Screening Method O V <br /> m• — <br /> Tracking Sheet - n ) <br /> ft. = L <br /> SPOILS <br /> Storage Method Of Dew—t45 MATERIALS/DEVEI.OPMENT <br /> Contamination Noted - ( y/t5� 2,. 15014 �C- <br /> Storage Location 011) 5l'R�' Casing type 40 <br /> Blank ft. Screen <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water 2 Bags sand/gravel 1 r S <br /> Mix Ratios >2G /SLS GFilter Pack type/siz- <br /> 14 <br /> Installation <br /> Method Surge Block: - (y/ ) <br /> Quantity Installed /0 72-Ls Discussed with geologist: - n ) Cw 4r97 <br /> Type of method <br /> EH 29 29 <br />