Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date:— I 1 I oy <br /> tCON�CI7pN <br /> Premise Address: I I lqe <br /> Well No.:�NTotal Depth O ` <br /> Screen Length (from) ` <br /> Filter Pack (from) (to) 1 t r <br /> Inspector. Bentonite -- —(to)�� <br /> � (from) I— -�n—_([o) o r <br /> Permit No. q y S Grout (from) <br /> Drilling rig type (C0) ov ] <br /> Auger O.D. <br /> Drilling Company:_ kl=j � Completion - Stov��a�Iti boz (cu— cl�— <br /> Driller. ----rr <br /> T <br /> Consultant_ I casingheight <br /> Geologist <br /> dn-t a <br /> ASCVE-GAC4JND <br /> SPECIAL PERMIT INFO. COWLETCN CMilSt130X <br /> Cm;rd Sufxy ._ cOMPL`mCN <br /> Distance to server line <br /> Domestic well on site - ( r pts <br /> If yes, location an ante - <br /> too. ft. <br /> SAMPLING = o <br /> ilornd <br /> Holding g Temperature1o1ro soelcn = 3 <br /> Method <br /> Screening Method — Sravdyadc <br /> Tracking Sheet . ( /n <br /> SPS -�ft. — <br /> tf. <br /> Storage Method_ <br /> Contamination Not <br /> CROS ed . (y ) MATER7ALS/DEVE[OPMENT <br /> Storage Location 5 <br /> ' Atcltis4 Casing type_a ' pyt <br /> Blank i o% fL Screen_ fr Slot size <br /> �OZU <br /> Bags cement <br /> Depth to water n/ 6 S I Buckets bentonite <br /> Mix Rarios v Bags sand/gravel N ZY <br /> Installation Metho Filter Pack type/size <br /> Quantity Installed Surge Block: - <br /> EH 29 29 n ) <br /> Discussed with eologist: - (Y/0 <br /> Type of method <br /> -------------i <br />