Laserfiche WebLink
OONITORING WELL INSTALLATION REP* <br /> Date: c�' J •C� a CONSTRUCTION <br /> Ctt--t of 5 c�C TO' V"-tkt-v( I V p <br /> Premise Address: ✓ o ( Sta�h.', 0" Total Depth I <br /> �7rz Screen Length (from) 100. (to) S 5• <br /> Well No.: LO J > Filter Pack (from) I V(o (to) $5 <br /> p Bentonite (from) ?15 (to) 92. <br /> Inspector: N SSC Grout (from)—(to)— <br /> Drilling <br /> from) (to)Drilling rig type YYt. cl rotc-�j <br /> Permit No. Auger O.D. ci�/8 u I.D. <br /> 5 Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: ROb SC.IL✓D� casing <br /> height <br /> Consultantn�.¢..0�v�-e -tv�c.E-�- K CCy✓1 T <br /> Geologist 11 � o T <br /> ABOVE-GROUND <br /> COMPLETION CHFIZ Y43OX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Grourd Surface <br /> N/a $1�nc wcli <br /> Distance to sewer line grout <br /> cam} �2 <br /> Domestic well on site - (y/� <br /> If yes, location and distance - ft' <br /> V�fi ft, ft. <br /> nmt <br /> Ab <br /> — e <br /> voblaY =_ c <br /> SAMPLING = ° <br /> slotted — B <br /> section <br /> Holding Temperature No e colt e S� <br /> Method = D <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) <br /> SPOILSIOg. S4YtmP 1 0 _TD <br /> 101 ta¢r�rr}e <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location50O•t't'N 04 a LOSS Casing type Orr P VCS <br /> C'A-h�)s/W'-'a Ptctc-eck �P fi 'i Blank 85.y ft. Screen 15 ft. <br /> 1� wt1l ptctc JP 8.1 5 . d Slot size . D lU stat"tess 5({e l <br /> GROUTING ludtsP�scc� westmurgl � -Lmc�ta� Bags cement <br /> oo.-dev Buckets bentonite fnP I - 50 ( - <br /> Depth to water Bags sand/gravel /2 - loo Uo <br /> Mix Ratios Filter Pack type/size � I C <br /> Installation Method M1e (34 'C4,,Q t tiartW) Surge Block: - (`J n ) <br /> Quantity Installed Discussed with geologist: - 6) n) <br /> r�a� Type of method_ YVXor-K, <br /> EH 29 29 A " <br /> '' to`j2 bre" 4,- co+v�Cto, cGsthf volalay Ml-j- (1)5D1b loQ9/2394 HZD S41 <br /> / t3u-e,o4 w.ti-° $ape+get "t8 <br /> co.rlUctw c�i�.� <br /> �fb(cl4 - ��/S••pJortt��la cib.rveJ*� -{c 1 �N1Pnl 'L�'.� fb A`i,U0.rjz1 SD�.QM <br /> -- tag f LA6)bct5s <br />