Laserfiche WebLink
MONITORING WELL INSTALLATION REPOn <br /> —ounn c2oo vt 578dF 1.U�riGl✓y <br /> Date: NOye ¢ Zo / CONSTRUCTION <br /> Premise Address: 2.22,4- MaY1+-b1 Q „ ISA Total Depth d <br /> 1 Screen Length (from) (to) <br /> Well No.: \ / �/�/ Filter Pack (from) Z (to) <br /> BentoV i�.�C IV�C f1 T'�Yt e V Grout <br /> (from) (to) <br /> Inspector: rou (from) 3 (to) r <br /> Drilling rig type <br /> Permit No. ) 0 G, 3 '7 i L Auger O.D. njjL_ I.D. 6 l <br /> Drilling Company: <br /> Completion - S ve pipe/ stie bo� (circle one) <br /> _ S I / <br /> Driller: casing <br /> (2,1005 n'loren o� Err7eS height <br /> ConsultantAd'yanwed (��� E���;r p pots-q� y ♦ ' <br /> Geologist Q n 14 n i ra T E _ <br /> ABOVE-GROUND <br /> CO WF LETION 7rc�- <br /> Y <br /> 0X= <br /> I <br /> SPECIAL PERMIT INFO. Ground Surface <br /> _ � t <br /> Distance to sewer line rx/. grout <br /> Domestic well on site - <br /> If yes, location and distance - ft. <br /> ft. <br /> — -al <br /> = m <br /> b <br /> SAMPLING 1 tl u �� Zf — o <br /> S� Slotted — B <br /> aJ°Pm section — <br /> � . <br /> Holding Temperature '�'d /0 <br /> Method - _ _ �"�P� <br /> ,� <br /> Screening Method ) <br /> Tracking Sheety) n ) _ <br /> —c�1Zft. •�0 ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y/ n / <br /> Storage Location Casing type <br /> Blank 5 ft. Screen I ft. <br /> Slot size 6. 0 3 0 <br /> GROUTING Bags cement ' r • T -r 560 <br /> Buckets bentonite j1,w ` 0 �a �` <br /> Depth to water /�l �j Bags sand/gravel / 1 b <br /> Mix Ratios / 76 Filter Pack type/size <br /> Installation Method Surge Block: - (y <br /> Quantity Installed .2jq,2*&jj0_r t)-T &Dut Discussed with geologist: - / n ) <br /> Type of method <br /> EH 29 29 b v c.hel- <br />