Laserfiche WebLink
• r <br /> -..rJNITORING WELL INSTALLATION REPOiOl <br /> Date CONSTRUCTION <br /> CONSTRUCTION <br /> Premise Address: � Total Depth <br /> Screen Length (from) (to) <br /> Well No.: ALSO Filter Pack (from) (to) <br /> Bentonite (from) (co) <br /> Inspector. Grout (from) (to) <br /> .Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/cluistie box (circle one) <br /> Drilling Company: <br /> casing <br /> Driller.• IF <br /> height <br /> IFM <br /> Consultant <br /> Geologist JlFZ E,GRCUNp <br /> COWLEMN C}iRt - <br /> COt,AF_=T1CN <br /> L� CN <br /> SPECIAL PERMIT INFO. Ground SLzf <br /> grout <br /> Distance to sewer line <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance - ft. <br /> ft. <br /> w <br /> = oC <br /> SAMPLING sloroi <br /> secicn <br /> Holding Temperature <br /> Method <br /> Screening Method ' — <br /> :t. <br /> Tracking Sheet - (y/n) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location Casing type — <br /> Blank fc. Screen ft. <br /> Slot size_ — <br /> GROLMNG Bags cement <br /> Buckets bentonite — <br /> Bags sand/gravel <br /> Depth to water — <br /> Depth <br /> . Filter Pack type/size <br /> Mix.installation Method Surge Block: - (y/n ) <br /> Quantity Installed Discussed vAth geologist: - (y/ n <br /> Type of method <br /> EH 29 29. . <br />