Laserfiche WebLink
g1TORING WELL INSTALLATION REPOR <br /> Date: ����')/�Z CONSTRUCTION <br /> Premise Address: (;Z- y _ Total Depth 90 <br /> Screen Length (from) 'lel° (to) <br /> Well No.: A4 Filter Pack (from) O (to) ' <br /> Q Bentonite (from) (to) <br /> Inspector: _ � �''I 1 Grout (from ' (to) 0uUk t �i <br /> ,- Drilling rig e <br /> Permit No. _q - 31 Auger O.D. I.D. a q <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing _ <br /> 7- height <br /> Consultant n, <br /> Geologist ._ <br /> ABOVE-GACUNO CNAtSiY-BOX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surfacs <br /> Distance to sewer line 3 grout <br /> Domestic well on site - ( y n 47 1 ft. <br /> If yes, location and distance ft. <br /> S6 ft. <br /> SAMPLING — <br /> •lora. — c <br /> • racticn <br /> B <br /> Holding T perature ;M <br /> Method fc =i _ ¢7f°t Pack <br /> Screening Method 4n <br /> :Cw - <br /> Tracking Sheet -ry/ n ) <br /> C) ft. -� — '71> tt. <br /> SPOILS <br /> Storage Method LCL"S f '06C z) C-ev-e- -- MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) 7 <br /> Storage Location, l ScJ Casing e V�t✓ <br /> Blank ft. Screen 70ft. <br /> Slot size . t7 2.O <br /> GROUTING Bags cement /0-12-- //tVf- <br /> Buckets bentonite <br /> Depth to water S Bags sand/gravel C 4GS <br /> Mix Ratios Filter Pack type/siz 3 <br /> Installation Method Surge Block: - ( y/ n <br /> Quantity Installed Discussed with geo ogist: -,�jyj/ n ) <br /> Type of method L <br /> EH 29 29 <br />