Laserfiche WebLink
MONITORING WELL INSTALLATION rt--PORT <br /> Date: CONSTRUCTION <br /> Premise Address: 1 ow(L 5- Total Depth l (o <br /> Screen Length (from) I dv (to) f 10 <br /> Well No.: ? Filter Pack (from) IQ,$ (to) r� <br /> Bentonite (from) (to) <br /> Inspector: r r u Grout (from) (to) <br /> Drilling rig type <br /> Permit No. '�;- Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: (� en,c.c.,�_ <br /> Driller: <br /> casing <br /> height <br /> Consultant �� <br /> Geologists / _ _ T► <br /> ABOVE-GROUND <br /> CO MP LET;0 N CHRSTY-Box <br /> SPECIAL PERMIT INFO. Ground Surface COMPLETION <br /> Distance to sewer line - grout <br /> Domestic well on s�ds�tan <br /> If yes, location and �h• <br /> Cf r <br /> �c7o it• ft. <br /> tl <br /> SAMPLING <br /> �tottad — c <br /> sec�ron = � <br /> Holding Temperaturecc1n %?, <br /> Method- 1 _ <br /> Screening Method r I 0 <br /> Tracking Sheet - t–v-)/ n ) _ <br /> SPOILS <br /> Storage Method Q)ti>^ MATERIALS/DEVELOPMENT <br /> Contamination Noted - n ) <br /> Storage Location- QjY �Ao Casing type ��V�_ <br /> Blank��0 C ft. Screen <br /> Slot size i U Z.C <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water_ ^� a,�� Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Block: - ( y <br /> Quantity Installed Discussed with geotTy'gist: n ) <br /> EH 29 29 Type of method <br /> 7, A4— 0 pop <br />