Laserfiche WebLink
.JNITORING WELL INSTALLATION REPOKti <br /> 4j ��Q <br /> Date: 4i 0 �"` CONSTRUCTION <br /> Premise Address: Total Depth c-- <br /> Screen Length (from) (to) <br /> Well No.: Y1� Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: ��K��'� Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Drilling Company: <br /> y�7 Completion - Stove pipe/christie box (circle one) <br /> Driller: casing <br /> �� �� �� height <br /> Consultant /T <br /> Geologist •� T <br /> ABOVE-GROUND CHRZTY43OX <br /> COMPLETION COMPLETICN <br /> SPECIAL PERMIT INFO. p Ground Surf=* <br /> Distance to sewer line �U grout <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - <br /> R. <br /> AP-0 <br /> SAMPLING dotted <br /> &*don � <br /> Holding Tmperature gr,vw Pack <br /> Method ��.�-�rh Z�-�� S� � <br /> Screening Method <br /> Tracking Sheet - (y/n ) <br /> SPOILS /U o <br /> c��drS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) n,f� <br /> Storage Location Casing type I U <br /> Blank S ft. Screen <br /> Slot size D`D 20 <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water 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 />