Laserfiche WebLink
IRONITORING WELL INSTALLATION REPO <br /> Date: ///2T CONSTRUCTION <br /> Premise Address: � � � (�� Total Depth <br /> Screen Length (from) (oa (to) <br /> Well No.: �S' % Filter Pack (from) &0 (to) S6 <br /> Bentonite (from) 3- (to) S� <br /> Inspector: Grout (from)— F�f (to) <br /> Drilling rig type c4k-tr 71V <br /> Permit No. Auger O.D. I.D. <br /> 5� <br /> Drilling Company: Completion - Stove pipe/christie box (circle one) <br /> Driller: <br /> height <br /> Consultant / <br /> Geologist 7F <br /> ABOVE-GROUND icr <br /> Y-BOX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surfxe T <br /> Distance to sewer line sd grout <br /> Domestic well on site - ( yC 1 5V <br /> If yes, location and distance - ft. <br /> = m <br /> — o <br /> = m <br /> _ <br /> SAMPLING slatted = ' <br /> sericn — <br /> Holding Temperature = VIVW P <br /> Method = <br /> ack <br /> Screening Method = " <br /> Tracking Sheet y n ) _ <br /> .SC 0 ft. ft. <br /> SPOILS n <br /> Storage Method /sMATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y ,p <br /> Storage Location Casing type '1 '0S'4 46 / V <br /> Blank ft. Screen <br /> Slot size .0/0 " <br /> GROUTING Bags cement /0 t /0 / <br /> Buckets bentonite— <br /> Depth <br /> Depth to water r �U Bags sand/gravel /Yj- <br /> Mix Ratios t 35 AiFilter Pack type/size Z R <br /> Installation Method Surge Block: - (y n' ,� � <br /> Quantity Installed = / U Discussed with geologist: - (y"�J <br /> Type of method <br /> EH 29 29 <br /> 1( ` t` 3� <br />