Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: I ct I D 7i CONSTRUCTION <br /> Premise Address: L-(O S TV\0,_ V\ Total Depth <br /> L 1 Screen Length (from) (to) <br /> Well No.: ( (n) — Filter Pack (from) n (to) _ <br /> Bentonite (from) ei (to) sZ. <br /> Inspector. 1-)-k .r r x ' Grout (from) Ft (to) �4 <br /> Drilling rig type <br /> Permit No. -2, Auger O.D. (O " I.D. <br /> Completion - Stove pipe/clu-isde box (circle one) <br /> Drilling Company- Clcnacle19 4 <br /> Driller. (L� (C _� casing <br /> height <br /> Consultant C-i \A\4 <br /> ^ T <br /> Geologist ABCVE-GR UND C}4ist(30X <br /> COMPLETION COMPLETICN <br /> SPECIAL PERMIT INFO. G`c'rd S�aO' + � <br /> prwt <br /> Distance to sewer lin <br /> e <br /> Domestic well on �rance <br /> n ) <br /> If yes, location an _ 52- <br /> a <br /> SAMPLING tlotrd <br /> soc'on —_ <br /> Holding Temperature = p,vd F-XX <br /> Method <br /> Screening Me = <br /> Trac king S e[ - (y/ n) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted -W n) r, <br /> Storage Location 1,A; 4th Casing type c{ eve <br /> Blank ft Screen K. <br /> Slot size 630 <br /> GROUTING Bags cement L 3 <br /> Buckets bentonite <br /> Depth to water Bags sand/gravcl <br /> Mix Ratios Filter Pack type/size <br /> Installation Methods Surge Block: - (y/ n ) <br /> Quantity Installed n, Discussed with geologist: - ( y/ n) <br /> Type of method <br /> EH 29 29 <br /> 0 <br />