Laserfiche WebLink
1 <br /> q1ONITORING WELL INSTALLATION REPO <br /> bldK p ' <br /> Date: �'�o '� q Q CONSTRUCTION <br /> Premise Address: c /// (�/ Su �� Total Depth L V <br /> Wel] No.: <br /> P�w'i Screen Length (from) (to) <br /> Filter Pack (from) $ y (to) <br /> Bentonite (from) :!r� (to) <br /> Inspector: Grout (from) (to) 0O i <br /> Permit No. ��- <br /> 8�(,� Jr3 U Drilling rig type riL <br /> j�``/ Auger O.D. I.D, AT <br /> Comple ' n - ove pipe/christie box (circle one) <br /> Drilling Company: // £ 4 [� c� /,_ � p _ <br /> Driller: CL. �� L 7�/P�"r"� cas ng <br /> �/ � heig t <br /> Consultant_ /r_co/ pu- <br /> Geologist / / y M N46 _ <br /> ABOVE-GROUND <br /> COMPLET �s'/ CHMM-80X <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surf <br /> Distance to sewer line /G O of0"t <br /> Domestic well on site - y ) <br /> r <br /> If yes, location and distance • ! �E 1 ft. <br /> �� <br /> _7ra_ft. <br /> — m <br /> — o <br /> = m <br /> SAMPLING <br /> �lottad 8 <br /> tarion <br /> Holding Temperature 441X ' <br /> Method �7 gnviW Pack <br /> Screening Method = <br /> Tracking Sheet - (y/ n ) <br /> SPOILS 0' <br /> r 3 � <br /> �/ �ir ��� G �z <br /> Storage Method G to <br /> T <br /> Contamination Note - (y/ n ) <br /> Storage Location Casing type amu. <br /> Blank (af) ft. Screen <br /> Slot size ld <br /> GROUTING Bags cemen CCs LS <br /> Buckets ben ni�22 <br /> Depth to water s Bags sand/gravel <br /> Mix Ratios ho t CSC 'i lSU S Filter Pack type/size 7- <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />