Laserfiche WebLink
MONITORING WELL INSTALLATION REPbRT <br /> Date: ' CONSTRUCTION - <br /> Premise Address 1 2'Y(v l7'� Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> 4n2l <br /> Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> -ff-11, � n Completion- Stove pipe/christie box (circle one) <br /> -HrHhRg Company: (�(� <br /> Driller: -T=,casing <br /> height <br /> Consultant <br /> Geologist •- <br /> A80YE-GROUND <br /> COMPLETION CtiAiS?Y-80X <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Sur wo <br /> Distance to sewer line <br /> grout <br /> Domestic well on site - (y/n ) <br /> If yes, location and distance - ft' <br /> ft. ft. <br /> o � t <br /> SAMPLING sbitad ` _ <br /> b� sacaon <br /> Holding Temperature. ; <br /> Methodack <br /> = P <br /> Screening Metho rr — <br /> Tracking Sheet /n) '' — <br /> tt. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> 6 <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water 5 Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />