Laserfiche WebLink
fo <br /> OONITORING WELL INSTALLATION REPOMf <br /> Date:!�I I�� CONSTRUCTIO�N/ � � <br /> Premise Address: <br /> L/lh� f��Q/�if� F� Total Depth ff°al/ <br /> /�J c 7 3a S( Screen Length (from) (to) <br /> Well No.: �� Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) (to) <br /> //JJ Drilling rig type <br /> Permit No. 40Z� G / Auger O.D.jVdX4e.=& I.D. 6 2 <br /> �r Drilling Company: <br /> Completion - Stove pipe/christie box (circle one) <br /> casing <br /> }R Y7 �! <br /> Driller: /QLD c�{Gr l /�� .kap <br /> height <br /> Consultant GyZ <br /> Geologist <br /> ABCVF-GROUND <br /> COkFLEfION Ct AISTY BOX <br /> C <br /> SPECIAL PERMIT INFO. Ground Surface 7— <br /> Distance to sewer line CJ`O grout <br /> Domestic well on site - ( y <br /> If yes, location and distance - ft' <br /> 4s•er/7f 70 <br /> - m <br /> — o <br /> SAMPLING 7d dottad = c <br /> wc6cn <br /> Holding Temperature <br /> Method — gra�Pack <br /> Screening Method = <br /> Tracking Sheet - ( y/ n ) -- / <br /> SPOILS ' <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type Z <br /> Blank (6 b ft. Screen <br /> Slot size Oi0'" <br /> GROUTING Bags ceme t f 86) P' I(6) 517 <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios' W"'t 7 Filter Pack type/size \2 rZ <br /> Installation Method �^ Surge Block: - (y <br /> Quantity Installed a .i10 , u a 2us/ Discussed with geologist: - (y j)) <br /> d Type of method <br /> EH 29 29 �\ �Sn 2,1/ p <br /> -pp y�I�D1 �5 �/ 4 5-]7EI-1 <br /> o f FTS- 30 e ,Q-57 6'/ <br /> P'�"- 7 <br />