Laserfiche WebLink
0 &E_ OF� <br /> MONITORING WELL INSTALLATION REPORT <br /> Date:— / GRb - <br /> CONSTRUCTION <br /> Premise Address: /� Co d C Well No. /�'/ '✓ v <br /> Inspector: , <br /> Total Depth / S <br /> Screen Length In . 5 •S <br /> Filter Pack to/. S - <br /> �� Bentonite `Pe/ll is C�- S- <br /> Permit No. Grout 3 Z5 <br /> Consultant e-edsla C/ G Completion-Stove. pi Christie box <br /> Geologist G�., ; <br /> Auger O.D. <br /> Auger I.D. <br /> SAMPLING <br /> Holding Temperature stok'uP <br /> Method <br /> VM <br /> Screening Method I <br /> ABOVEGROUND CHRISTY•BOX <br /> Tracking Sheet (y ) COMPLETION COMPLETION <br /> SPOILS Q Ground SuAaCY <br /> Storage Method 0'7 5/le glocA <br /> Contamination Noted e no �� tt• <br /> Storage Locationn <br /> — o <br /> SPECIAL PERMIT INFO. = z <br /> — o <br /> ° Distance to sewer line dottrel = $ 2. <br /> &&don <br /> Domestic well on site - yes/� <br /> If yes, location & distance - — graveiPack <br /> �S <br /> GROUTING <br /> MATERIALS USED: <br /> Depth to water/ 5-2 Casing tvIDe Pvc <br /> Mix Ratios_ Blank ft. Screen a0 ft. <br /> Installation Me hod /'CMMlL Slot size c2 <br /> Quantity Installed Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel <br /> Filter Pack type/size <br /> Total Billed Time Per Site <br /> Date Permit Finalized <br /> 1 <br />