Laserfiche WebLink
a <br /> r IE Z-- OF <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: ,f _ CONSTRUCTION <br /> Premise Address: ✓11� L� Well No. C r L <br /> Inspector• Total Depth <br /> Screen Length <br /> Filter Pack r'l- <br /> Bentonite Pellets <br /> Permit No. �G' 7_07 Grout ^4 <br /> Consultant /' i Completion-Stove pipe hris i:& 0!� <br /> Geologist <br /> Auger O.D. <br /> Auger I.D. /. <br /> SAMPLING T �' <br /> G sticit-up <br /> Holding Tem rature <br /> Method <br /> T <br /> Screening Method PIA T <br /> ABOVE-GROUND CHRISTY-BOX <br /> � <br /> Tracking Sheet n) COWIPLETION COMPLETION <br /> Ground SLwfwo <br /> SPOILS <br /> 0r� / <br /> Storage Method �. S <br /> Contamination Noted - yes no <br /> Storage Location -�✓J<-P�e <br /> SPECIAL PERMIT INFO. c <br /> 0 <br /> Wo6d <br /> Distance to sewer line vection S <br /> Domestic well on site - yes no _ VmP <br /> ack <br /> If yes, location & distance <br /> GROUTING ` <br /> MATERIALS USED: I <br /> Depth to water Casing ty e Pvt-Z r <br /> Mix Ratios Blank -?,,§ ft. Screen / ft. <br /> Installation Method Slot size D <br /> Quantity Installed G Bags cement <br /> Buckets bentonite r 4 <br /> Bags sand/grave # s c <br /> f Filter Pack type/size3�;.-.L <br /> Total Billed Time Per Site IA <br /> Date Permit Finalized <br />