Laserfiche WebLink
1%,. .. <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: j CONSTRUCTION <br /> i <br /> Premise Addmn�a'o" <br /> M'/ ,U ` Well NDept <br /> Inspector:_ <br /> Total Depth < <br /> Screen Length <br /> Filter Pack <br /> Bentonite Pellets <br /> Permit No. ! 2� Grout A�Aj (A,1,a,,A�4, <br /> Consultant 64 Completion-Stove pipe Christie box <br /> Geologist (",,,, y-4 <br /> Auger 0.D. ( U <br /> Auger I.D. <br /> SAMPLING <br /> (/d <br /> Holdingd�eem erat /�� S�+rP <br /> Method <br /> /I411Ls <br /> Screening MethodNN <br /> ABOVE- ND CHRISTY-BOX <br /> Tracking Sheet y ) COMPLETION COMPLETION <br /> SPOILS Ground Surlaa <br /> grout <br /> Storage Method '�`( -t-S r, <br /> Contamination Noted - ye no <br /> Storage Location <br /> SPECIAL PERMIT INFO. <br /> I — o <br /> Distance to sewer line til a s�ictian _ $ <br /> Domestic well on site - ye /n <br /> If yes, location & distance - gmW pack <br /> GROUTING <br /> MATERIALS USED: <br /> / <br /> Depth to water ZS�3 Casing ty er <br /> 'PP(')� 1 <br /> Mix Ratios C Blank__Z_ ft. Screen ft. <br /> Installation Method /2e�o� C Slot size • D ., O <br /> Quantity Installed '/' r Bags cement / <br /> Buckets benton�S' <br /> Bags sand/gravel / <br /> Filter Pack type/size . 7� j <br />