Laserfiche WebLink
• MONITORING WELL INSTALLATION REPORT <br /> Date: y �," � � CONSTRUCTION <br /> Premise Address: �'r/r YV " 1211 -t Total Depth <br /> Screen Length (from)--(t0)- <br /> Well <br /> from)_ (to)Well No.: Filter Pack (from)_ (to) <br /> Bentonite (from)_ (to) <br /> Inspector. l Grout (from)--(to)- <br /> Drilling <br /> from)_ (to)Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> he_ght <br /> Consultant �-P� / u � � T <br /> T <br /> Geologist A80VE-GRCUND <br /> COMPLETCN comp ncN <br /> COMPI.ETICN <br /> SPECIAL PERMIT INFO. Ground Surfact + �� <br /> proof <br /> Distance to sewer line PIZ <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - tt. <br /> tt. _ <br /> i. <br /> SAMPLING �locad = c <br /> socicn <br /> Holding Temperature 7 " _ pavalPadt <br /> Method " <br /> Screening Method <br /> Tracking Sheet - / n ) 7Y <br /> tt. = tt. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type <br /> Blank ft. Screen_-------ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />