Laserfiche WebLink
_ ,ONITORING WELL INSTALLATION REPOr �.r <br /> 1 Date:, , _ - - [�,'�4 � CONSTRUCTION <br /> Premise Address: Gly r lElw Total Depth <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) (to) 3 <br /> Bentonite (from) (to) 34b <br /> Inspector. Grout (from) r`(to) <br /> Drilling rig type N 1 <br /> Permit No, "+. - Auger 0'D. jal <br /> Completion - Stove.pi 'stie box (circle one) <br /> Drilling Company:_ heIght <br /> r <br /> Duller• �� .--_ casing " <br /> Consultant —EW7:F' <br /> Geologists <br /> ABOVE•GRCUND CNRISTY•aOX <br /> 0OWLEMN CCMPLEMN <br /> RECTAL PERMIT INFO. C3rnerd Surfac: <br /> Distance to sewer line <br /> Domestic well on site - {y/D <br /> If yes, location and distance - tL <br /> ft. <br /> Nr. <br /> y � <br /> i5r - .rCe 1 <br /> SAMPLING obro.f _ <br /> w i*dcn <br /> Holding Temperature 4"G r — 'VA I <br /> ack <br /> Method 1 Com' <br /> Screening Method ME* — <br /> Tracking Sheet - n ) <br /> a" �._.tL tt. <br /> SPOILS <br /> Storage Method DOI MATERIALSnEVELOPMENT <br /> Contamination Noted - (y/ n ) V;, <br /> Storage Location. DO AiY44c�cwr SES Casing type N� <br /> Blank JL Screen fL <br /> Slot size <br /> GROUTING Bags cement rpt:- <br /> Buckets bentonite <br /> Depth to water Z Bags sand/gravel <br /> Mix Ratios Filter Pack type/size Goy <br /> Installation Method Surge Block: - (y <br /> Quantity Installed - Discussed with geqOist: - 6/ n) <br /> Type of method <br /> EH 29 29 GwbwCwsl *#o&K&A) <br />