Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: I L c) I �i5 <br /> CONS��(ON <br /> Premise Address: AA <br /> wt W- Z(rj SI Total Depth 60 <br /> Well No.: III (Z / A Screen Length (from) S (to)- <br /> � rlev��F�t,�4LcvQe Filter Pack (from; �[o� `T <br /> Inspector: _� r ����y Bentonite (from(from)_ (to)) �_ <br /> Permit NoI '"-'�l'�11t Drilling rig type(from)�(to)�_ <br /> Auger O.D. I.D. <br /> Drilling Company:_ j r, R P p Q[ Completion - Stove pipe/christie box (c— ircleone) <br /> Driller: --rr <br /> casing <br /> Consultant i!� F- � height <br /> crkm <br /> ABOVE-GROUND <br /> SPECIAL PERMIT INFO. COMPLETION C-Hslsrr-sax <br /> Ground SuAxsOON <br /> Distance to sewer line r 1— <br /> Domestic well on site - n ) grout <br /> If yes, location and stance - <br /> ft. <br /> SSrft. ft. <br /> i q <br /> SAMPLING — m <br /> c <br /> Holding Temperature m , �bmed ` <br /> wctlon — B <br /> Method <br /> Screening Method�( p / _ = gravel pack <br /> Tracking Sheet n ) =«' <br /> -' — <br /> SPOILS —�ft• <br /> tt. <br /> Storage MethodSo <br /> Contamination Noted - (y n ) MATERIALS/DEVELOPMENT <br /> Storage Location <br /> Casing type 7- " 7 <br /> Blank--- S-r g• Screen <br /> GROUTING Slot size .020 ft- <br /> Bags cement <br /> Depth to waterer Buckets bentonite_ <br /> Mix Ratios Bags sand/gravel 7 . S <br /> Installation Method Filter Pack type/size <br /> Quantity Installed �K< Surge Block: - (Y/�n <br /> Discussed with geologist: - ( y <br /> EH 29 29 Type of method <br />