Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> CONSTRUCTION <br /> Date: <br /> M�ct�s: Total Depth <br /> Premise Address: / Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Grout (from) _ (to) <br /> Inspector. /\ Drilling rig type <br /> Auger O.D. I.D. <br /> Permit No. Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> casing <br /> Driller. —Fheight <br /> Consultant -CWT <br /> Geologist - AgpVE-GFICUND C4-S*TY-30X <br /> COMSPLrc rCN GCMPS-ETICN <br /> Ground Sutacs <br /> SPECIAL PERMIT INFO. <br /> peat <br /> Distance to sewer line <br /> Domestic well on site - (y/ n) ft. <br /> If yes, location and distance - <br /> o <br /> ^ C <br /> _ o <br /> -- <br /> SAMPLING soc'icn <br /> Z _ 9MV01 pack <br /> Holding Tem?erature <br /> Method ± ' _ <br /> Screening Method -^ —_ <br /> Tracking Sheet - (y/ n) <br /> SPOILS_ <br /> MATERI ALS/DEVEI.OPMENT <br /> Storage Method <br /> Contamination Noted - (y/ n) Casing type <br /> Storage Location Blank ft. Screen <br /> Slot size <br /> Bags cement <br /> GROUTING Buckets bentonite <br /> �v rO <br /> Bags sand/gravel <br /> Depth to water Filter Pack type/size <br /> Mix Ratios Surge Block: - (y/ n ) <br /> Installation Method Discussed with geologist: - (y/ n) <br /> Quantity Installed Type of method <br /> EH 29 29 <br />