Laserfiche WebLink
\ SOMQNITORING WELL INSTALLATION REP <br /> l <br /> Date: CONSTRUCTION <br /> � ^ <br /> Total Depth (OCJ <br /> Premise Address: /!52JX~D S� Screen Length (from) (to) — <br /> Well No.: lr Filter Pack (from) D (to) _ <br /> Bentonite (from) (to) <br /> Grout (from) <br /> Inspector: <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> E Completion - Stove pipe/chrislie box (circle one) <br /> Drilling <br /> Compnany: ' <br /> Driller: __ cas ing <br /> height <br /> Consultant = <br /> Geologist Azd <br /> ABOVE-GROUND CHR <br /> COMPLE CN ON <br /> SPECIAL PERMIT INFO. Grourid Surlaca <br /> Distance to sewer line K111Grout <br /> Domestic well on site - (y/ n <br /> If yes, location and distance - ft. <br /> J J <br /> o <br /> SAMPLING _ <br /> alottad � c <br /> N. <br /> Holding Temperature G _ gm�pack <br /> Method ` — <br /> Screening Method 6V'*- <br /> Tracking Sheet - y n ) — <br /> SPOILS C 1 <br /> Storage Method �/ MATERIALSZDEVELOPMENT <br /> Contamination Noted - y n ) <br /> Storage Location A Casing type z� V _ <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite l <br /> Depth to water -53 Bags sand/gravel 7-+ T� <br /> Mix Ratios - f° If Filter Pack type/size 3 <br /> Installation Method Surge Block: - (y n } <br /> Quantity Installed Discussed with geologist: <br /> - (y/n ) <br /> EH 29 29 Type of method <br />