Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: y� CONSTRUCTION <br /> Premise Address: Total Depth_ 1aA15 <br /> Screen Length (from)' i (to) C_� <br /> Well No.: V:.W Filtet Pack (from) r (to)_L <br /> Tcav�S, Ie' (from) 5 (to) lC <br /> Inspector: , Grout (from) P)% (to) ` <br /> Drilling rig type M coiat-�� <br /> Permit No. Auger O.D. t 3/-i' ' I.D. <br /> Completion - Stove pipe/ stie box (circle one) <br /> Drilling Company: ( ?Ya � �, A <br /> Drillez:_��, casing <br /> height <br /> Consultant �� 7 <br /> Geologist s\r"M"2� ._ <br /> ABOVE-GROUND <br /> COMFLETON CtiALM_BOX <br /> SPECIAL PERMIT INFO. Grour)d Surface COMPLETION <br /> Distance to sewer line grout <br /> Domestic well on site - (y/n) <br /> If yes, location and distance - ft- <br /> ...L2�=' <br /> ' � m <br /> r <br /> SAMPLING — o <br /> slotted �: <br /> ' sa•caon �� _ <br /> Holding Temperature N <br /> Method — VIV94 Pack <br /> Screening Method = <br /> Tracking Sheet - (y/n) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location Casing type_ (o,' P\JC— (StAn. � <br /> Blank_0-125 �.15c�-\S`�t. Screen 120– \`_-O ft. <br /> Slot size v.U�Cp <br /> GROUTING Bags cement 2.\ <br /> -b-,w6' 3 <br /> Depth to water Bags �gravel�� <br /> Na Ratios Filter Pack type/size #`2J12 <br /> Installation Method _Sur e Block:_--_-(- /n <br /> Quantity Installed Discussed with geologist: - ( / n) <br /> EH 29 29 <br /> Type of method <br />