Laserfiche WebLink
MONITORING WELL INSTALLATION REPOR i <br /> Date: 0 fP- / 3 2-0 1 CONSTRUCTION <br /> T <br /> Premise Address: 4_ Total Depth <br /> }�n Screen Length (from) L 0 (to) <br /> Well No.: /y t W- it Filter Pack (from) O (to) le"V <br /> Bentonite (from) (to) J�S— <br /> Inspector: tA# M6JA114h11,, _ Grout (from) Gs- (to) <br /> Drill <br /> Permit No. Auger <br /> O nig <br /> type Cn'I 7k- <br /> Permit <br /> �I.D.OOG3 '71Z <br /> Completion - Stove pip Christie box circle one) <br /> Drilling Company: x �✓ x <br /> Driller: N Y v casing <br /> C4 r to s t-tn.vd f7 T height *-60 <br /> Consultant31Geologist ABOVE-GROUND <br /> p� p COWPLET{ON <br /> COMPLETION <br /> SPECIAL PERMIT INFO. 5'•2,1' UfYA_ Ground Surface <br /> Distance to sewer line "7 3F/ grout <br /> 0 3.d <br /> Domestic well on site - ( y n 3SI L 3P G S- ft <br /> If yes, location and distance - <br /> Y6' - o' ?0"( G ft. <br /> yr, . 7o n, <br /> = m <br /> O <br /> .K. t <br /> SAMPLING ��/ / = c <br /> '— g Sig, �S�i,,ly»D/GJ slatted _ <br /> Holding Temperature_ _ <br /> Method = 4 ` <br /> 1 C e-�r1.�rrt �� — <br /> Screening Method — <br /> Tracking Sheet / n ) .r <br /> ft. <br /> SPOILS <br /> Storage Method f, •c MATERIALS/DEVELOPMENT <br /> Contamination Noted - Vy n ) <br /> Storage Location I'laJ- Casing type in a <br /> Blank (Z ft. Screen /0 ft. <br /> Slot size G • D Za " <br /> GROUTING Bags cementQujf .6t-< I <br /> 1. S7>Buckets bentonite " tf <br /> Depth to water Bags sand/gravel <br /> MixRatiosPkA�,rd vl• ,2 A }yb +%louoaN.Lf}/ie Filter Pack type/size <br /> Installation Method J ;f Surge Block: - ( y <br /> Quantity Installed � b4,}-p �fl rc�G Discussed with geologist: -CY n <br /> a ) <br /> r AA-0(Thy"-Type of method <br /> EH 29 29 J <br />