Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: 7/ /oS CONSTRUCTION <br /> Premise Address: S S�X� Total Depth <br /> Screen Length (from) S (to)� C <br /> Well No.: <br /> iL✓G✓ Filter Pack (from) 7 5 (to) <br /> Bentonite (from) $ (ro) <br /> Inspector. Grout (froth)• S (to) �< <br /> Drilling rig ty.ple <br /> Permit No. Auger C.D. _ LD. t' <br /> Completion - Stove pipe/chrisde box (circle one) <br /> Drilling Company: <br /> Driller: / casing <br /> he_'ght <br /> Consultant <br /> V <br /> Geologist 7 A3oVE-GRCU �,y <br /> Np ty-50X <br /> ETI <br /> COMPLETION CC%W CN <br /> SPECIAL PERMIT INFO. Crourd Sulxa <br /> grout <br /> Distance to sewer line <br /> Domestic well on site - (y/ n) ft. <br /> QT <br /> If yes, location and distance - ft. <br /> 1 m <br /> w <br /> C <br /> O <br /> SAMPLING rlorad <br /> socicn <br /> Holding Temperature P7P�F <br /> Method = _ <br /> Screening Method r - <br /> Tracking Shcet - (y/ n) / <br /> SPOILS <br /> Storage MethodMATERIALS/DEVELOPMENT <br /> Contamination Noted - Basint� g type—If1 , <� �6 <br /> Storage Location the j `�rL�e.to — Blank )C ft. Screen / —ft <br /> _ <br /> Slot size 0,010 <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel — <br /> 11 <br /> Mix Ratios Filter Pack type/size 1-4 <br /> Installation Method te Surge Block: - (y/n <br /> Quantity installed Discussed with geologist: -�}A/ n ) <br /> Type of method <br /> EH 29 29 <br />