Laserfiche WebLink
e j <br /> MONITORING WELL INSTALLATION REI-...ZrZ <br /> Date: M-� ` I /vo CONSTRUCTION <br /> Premise Address: o -I f')w Y I Total Depth I <br /> t Length (from (to) <br /> Well No.: Finer Pa m) <br /> mte ( (to) <br /> Inspector. J �/`� L1 Grout (fmm) (to) <br /> Drilling rig type C'-MA q-3 <br /> Permit No. Auger O.D. I.D. <br /> rA S Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller. C- casing <br /> height <br /> Coasultanr LAC <br /> /� Ydy�no� erO <br /> Geologist AC- <br /> ABCVEvr7CUN Cl�i15TY2CX <br /> CCb9'=7 SON CCMPIc"TiCN <br /> SPECIAL PERMIT INFO. Csaurd Sulaci <br /> i <br /> Distance to sewer line <br /> Domestic well on site - ( y/ n ) <br /> If yes, location and distance - <br /> V1wy59 it — <br /> Idated — c <br /> sectcn <br /> SAMPLING <br /> Holding Temperature M WI,W padc <br /> Method = <br /> Screening Method 1 •0� — <br /> Tracking Sheet - (y/ n) <br /> SL = tL <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casg type <br /> ,Blank Ssuer� <br /> GROUTING 1 Bags cement <br /> (� ers bentonite <br /> Depth to water 5� Bags s vei <br /> Ratios Filter Pack typ i$ <br /> Installation Method r ,m VA ;z Surge Block: - n ) <br /> Quantity Installed Discuss th geologist-. - ( , n) <br /> /� /// // ( T ofL/method <br /> EH 292999 �ri /6 V A4V'A� 4c -aulb,II� W/ CICS /t-*k � Yt/�✓ �Nljrv1 <br /> nUU`�I' ' JQ� r►� P0-MV ko lram ,I la�c� <br /> �(b { roLA� 0MX� @ n. '� Y3 m G foo-L. [ ilt do WA � hI� CAYr <br />