Laserfiche WebLink
10NITORING WELL INSTALLATION REPOnt <br /> Date: l ZI ob CONSTRUCTION / <br /> Premise Address: I D06 U/1 Total Depth tPd <br /> Screen Length (from) 9 (to) 576 <br /> Well No.: 7' 3 Filter Pack (from) &10 (to) $5 <br /> Bentonite (from) (to) <br /> Inspector: " Grout (from) (to) <br /> Q Drilling rig type <br /> Permit No. � �C J� Auger O.D. —� I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller:: 2(l F / 1��}' t casing <br /> height <br /> Consultant O <br /> Geologist �if.�bf.0 - A8- GROUND <br /> COMPLETION l87Y-BCX <br /> C <br /> SPECIAL PERMIT INFO. Ground SuAxe <br /> Distance to sewer line grout <br /> Domestic well on site - (} / n 53 tt <br /> If yes, location and distance - S k. <br /> 56 ft <br /> _= m <br /> q <br /> q <br /> -7, a <br /> SAMPLING slotted <br /> soc5an $ <br /> Holding Temperature — ,nom pack <br /> Method = <br /> Screening Method = <br /> Tracking Sheet - (y/ n ) <br /> SPOILS '' // <br /> Storage Method ay f ( y�q MATERIALS/DEVELOPMENT <br /> Contamination N - (y/ n ) n 1l <br /> Storage Locationote G 4AA Casing type ?- <br /> Blank__—$ i ft. Screen-2—ft. <br /> Slot size olo" <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel ?� <br /> Mix Ratios Filter Pack type/size Zr <br /> Installation Method Surge Block: - (y/n <br /> Quantity Installed Discussed with geolugist: - (y <br /> Type of method <br /> EH 29 29 <br /> ►4q , 3� <br />