Laserfiche WebLink
„ ,,, 0N'ITOPJNG WELL INSTALLATION RFA,...,r <br /> 1 <br /> i <br /> t <br /> Date: 2 f f CONSTR.UGTION <br /> � ! f <br /> Premise Address: !V � d � Total Depth GD <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) 43 <br /> Bentonite (from) (to) 41_ <br /> Inspector: AY Grout (from) 4 (to) L) <br /> Drilling rig type C <br /> Permit No. 9 I'3023 �L a} AL1 'W� Auger O.D. F3 R' <br /> Completion - Stove pipe/ uistie ox ( ' le one) <br /> Drilling Company: v Y G�5 162-)� <br /> �orvt 4---va,vtiS <br /> Driller: E)aoa GhEaey- _ casing <br /> 7- iheght <br /> Consultant Donala KL) t K <br /> Geologist V'e-\ >� <br /> OWI:�E CU D CHEZ Y-BOX <br /> COMPl.EMON c�t.�mON <br /> SPECIAL PERMIT INFO. G'nd Surfac* <br /> Distance to sewer line <br /> Domestic well on site - ( y/n <br /> If yes, location and distance - 46 ft. <br /> r <br /> a <br /> SAMPLING sfartd <br /> v secScn <br /> Holding Tempera a <br /> Method ICI — F <br /> Screening Method pt L2c <br /> Tracking Sheet - y/ n ) <br /> SPOILS Ptashc �W11-Qj l <br /> Storage Method { t �v��� MATERIALS EVELOPMIrNT <br /> Contamination Noted - <br /> Storage Location L. 0� Casing type 4D <br /> Blank Ift. Screen ft. <br /> Slot size EA 0 <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water �',,n,, t Bags sand/gravel <br /> Mix Ratios Z S °51UC '' Filter Pack type 'ze t <br /> Installation MethodSurge Block: - y <br /> Quantity Installed Discussed with geo ist: - y n <br /> Type of method 1” C <br /> EH 29 29 <br />