Laserfiche WebLink
rv10NITORING WELL INSTALLATION REPO <br /> Date: CONSTRUCTION <br /> Premise Address: / Total Depth <br /> Screen Length (from) '50 (to) 0 <br /> Well No.: 3 Filter Pack (from) 30 (to) g <br /> Bentonite (from) g (to) <br /> Inspector: Grout (from) Z (to) 1 <br /> 5 Drilling rig type C�'E 15 <br /> Permit No. �" `S 1715 Auger O.D. I.D. <br /> < <br /> Drilling Completion - Stove pipe/christie box (circle one) <br /> Compa/ny:J/ b <br /> Driller: 4 �e casing <br /> height <br /> Consultant IffT <br /> Geologist � � ABOVE-GROUND <br /> COMPLETION *N BO <br /> N <br /> SPECIAL PERMIT INFO. G=nd Surface <br /> Distance to sewer line6�r f <br /> Domestic well on site . (y n ft. <br /> If yes, location and distance - ft. <br /> l0 g, <br /> _ m <br /> = p <br /> m <br /> C <br /> SAMPLING slotted = *� <br /> on <br /> Holding Temperature T C— = Pam Pack <br /> Method =_ <br /> Screening Method = <br /> Tracking Sheet - (y/ n ) <br /> SPOILS {C <br /> Storage Method c� > MATERIALS/DEVELOPMENT <br /> Contamination Noted 7 Pye <br /> Storage Location 41n �� Casing type <br /> Blank Screen--=O--ft- <br /> Slot <br /> creen =Oft•Slot size •O <br /> GROUTINGBags cement Z ZIti <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel '7 <br /> Mix Ratios gtF`t t Filter Pack type/sizeQAUaAAAX— <br /> Installation Method e+r Surge Block: - (% n)� <br /> Quantity Installed 2 t A�)G Discussed with ge gist: - (y n� <br /> �� Type of method <br /> EH 29 29 ` / <br />