Laserfiche WebLink
0 0- <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: CONSTRUCTION <br /> CONSTRUCTION <br /> / m / <br /> Premise Address: Total Depth 7✓ <br /> 7 /' Screen Length (from)) (co) Z <br /> Syr- <br /> Well No.: &/ 1/Z � 7� 2- Filter Pack (from) � (to) 2,3 <br /> Bentonite (from)0 7 (to) 2 I <br /> Inspector. _!�//Y l Grout (from) <br /> Drilling rig type <br /> Permit No. -74-- -0-1? /`�� Auger O.D. ' <br /> Completion - Stove pipe chrisde boR (circle one) <br /> Drilling Company: p M <br /> Driller: ��r casing <br /> Y height <br /> Consultant iI ` <br /> Geologist <br /> IlB0VEdiACIJN0 CF4i M-BCX <br /> CCMPLETlON COMPLEEMCN <br /> SPECIAL PERMIT INFO. G=nd Sair+ <br /> Distance to sewer line otart <br /> Domestic well on site - (y/ n) Z/ (t, <br /> If yes, location and distance - <br /> 4Z a <br /> . q <br /> O <br /> SAMPLING dorsi <br /> secicn <br /> Holding Tempera reG = pavd pads <br /> Method <br /> Screening Mefhod <br /> Tracking Sheet - ( y/ n ) +' <br /> _ 3 92. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) 5 _ Q /�� <br /> Storage Location m ��v Casing type r�<vr /�J/e <br /> Blank 28 ft. Screen 20 ft. <br /> Slot size pd2� <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size 2-11,6 <br /> Installation Method / Gri..< Surge Block: - (y/ n ) <br /> Quantity Installed sr��, Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />