Laserfiche WebLink
weONITORING WELL INSTALLATION REPO. <br /> Date: kt oq /: � b r n Z CONSTRUCTTO <br /> NN <br /> Premise Address: 63 NQ`) t Dr1� Total Depth Z <br /> `�tl1� / Screen Length (from) -i 3- (to) <br /> Well No.: � Filter Pack (from) -2-4- (to) 5 <br /> Bentonite (from) (to) 3�h <br /> Inspector. M � S Grout (from) (to) <br /> Q -C) C Drilling rig type <br /> Permit No. I J Auger O.D. I.D. <br /> � �� Completion - Stove pip rrisde box 'role one) <br /> Drilling Company:_ <br /> Driller. 06rxl. q- casing <br /> �I / �� height <br /> Consultant � V\ F, <br /> VT <br /> Geologist TC)m a1 f1�dl1�Int'1r/1 <br /> CO&�I <br /> ABOVE-GROUNDCHRY-Box <br /> FLETION Z7ET10 <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Sudan 9 <br /> Distance to sewer line AI�xtDvjn grout <br /> Domestic well on site -t<y/ ) <br /> If yes, location and dis e - <br /> SAMPLING <br /> Boned <br /> soden <br /> Holding Temperature _ 73 Pack <br /> Method Z E2 <br /> Screening Method <br /> Tracking Sheet - (y/ n ) <br /> 22- _ ft. <br /> SPOILS <br /> Storage Method qM QW 5hC. MATERIALS/DEVELOPMENT <br /> Contamination Noted • n) Z r I <br /> Storage Location Q0 c W�S� Casing e <br /> Blank ft. Screen ft. <br /> Slot size OI O <br /> GROUTING Bags cement ew a /2 <br /> 1 Buckets bentonite 1 '5 <br /> Depth to water 15 — (Z Bags sand/gravel & <br /> Mix Rados Filter Pack type/size 2- /i <br /> Installation Method P eC Surge Block: - ( y n <br /> Quantity Installed Discussed with geo ogist: - (y <br /> Type of method <br /> EH 29 29 <br />