Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: J/ ! 1' CONSTRUCTION <br /> < `l /� <br /> < ' <br /> Premise Addrea 7/ lPiL -lay Well No. Y <br /> Inspector: /-� Com/( Total Depth 4/' <br /> Screen Length Z.O ' <br /> Filter Pack .7'/", = - <br /> c <br /> Bentonite Pellets <br /> Permit No. h — <br /> O�1 Grout r« .oe.�..✓'d U— <br /> Consultant �f}'— Completion-Stove pipe/,christie b x <br /> Geologist <br /> Auger O.D. /0/1 <br /> Auger I.D. " <br /> SAMPLING <br /> Holding Temperature OCi atickuP <br /> Method <br /> Screening Method Pl/l <br /> ABOVEGROUND CHRISTY•BOX <br /> Tracking Sheet, ( n) COMPLETION <br /> � COMPLETION <br /> SPOILS Grourd —_ <br /> ( proal <br /> Storage Method � �+� �- C�'tJli1-'-��- t <br /> Contamination Noted - yegr nod - n• <br /> Storage Location is, <br /> R• <br /> _0 <br /> = a <br /> - o <br /> SPECIAL PERMIT INFO. <br /> 0 <br /> Distance to sewer line G`^��' �icUos _ $ <br /> Domestic well on site - ye /n <br /> If yea, location & distance - — <br /> gravel pack <br /> GROUTING <br /> MATERIALS USED: <br /> Depth to water ?' Casing type <br /> Mix Ratios ,.-�,� r��,u.�.' Blank 2!J ft. Screen ft. <br /> Installation Method un-AlIc-c c- =x-�'- - �'1 Slot size X02-0 <br /> Quantity Installed -71A-( ) <br /> 4.3 Bags cement <br /> Buckets bentonite = / <br /> Bags sand/gravel Slk. <br /> Filter Pack type/size ' � <br />