Laserfiche WebLink
.GE_L_OF <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: Ll� Z�-- / C� CONSTRUCTION <br /> Premise Address: 3 All //e / Well No. r / <br /> Inspector: Total Depth S <br /> ;# Screen Length <br /> Filter Pack G/ <br /> Bentonite Pellets <br /> Permit No. v �J Grout - - <br /> Consultant Ll X44- Completion-Stove pip Christie_ box,) <br /> Geologist_K, <br /> Auger O.D. <br /> Auger I.D. <br /> SAMPLING - — -- <br /> �' atidc-up <br /> Holding Temperature <br /> Method <br /> —W <br /> Screening Me od ,. W <br /> ABOVE-GRO(JND CHRISTY-BOX <br /> Tracking Sheet (y6)— COMPLETION COMPLETION <br /> Ground Surlace <br /> SPOILS <br /> grout <br /> Storage Methodn. <br /> Contamination Noted - yes/no ft. <br /> Storage Location <br /> m <br /> SPECIAL PERMIT INFO. C� <br /> n� Q slotted � <br /> Distance to sewer line /V action <br /> Domestic well on site - yes/n _, gravWpack <br /> If yes, location & distance <br /> -1t. 1t. <br /> GROUTING <br /> MATERIALS USED: <br /> Depth to water Casing type <br /> Mix Ratios Blanker ft. Screen (i_ft. <br /> Installation Method Slot size <br /> Quantity Installed Bags cement <br /> Buckets bentoniteh <br /> Bags sand/gravel <br /> Filter Pack type/size <br /> Total Billed Time Per Site SL.Sc)) ; (57. Sv <br /> Date Permit Finalized <br />