Laserfiche WebLink
MONITORING WELL INSTALLATION REP-e-T <br /> 46 <br /> l�ji l CONSTRUCT[oN <br /> Date: - D <br /> Total Depth <br /> Premise Address: ScreenLength (from) (ta) <br /> nn <br /> Filter Pack (from) s-8/ (ta) G� <br /> L�Well No.: Bentonite (from) (to) <br /> ' Grout (from) (to)--LT <br /> �--- <br /> inspector: <br /> Drilling rig type <br /> Auger O.D. I•D. <br /> Permit No. Completion - Stove pipe/christie box (circle one) <br /> Dolling Company: <br /> ��^ cas 3119 <br /> Driller s :Fhe; <br />� ConsultantVV <br /> Geologist � �•,� <br /> �lBCVE RCiJNO C 4P LS I Y-W X <br /> CCW ET'AN COW'PL- ICN <br />�. GrnuridSutaca <br /> f SPECIAL PER T INFO. , <br /> > ncl-K <br /> Distance to sewer line . <br /> Domestic well on site C y <br /> if yes, location and distance - �-- - <br /> ' 7 <br /> O <br /> Sr1MPLING _ <br /> Holding Temperature <br /> Method <br /> Screening Method <br /> - ) <br /> 4. Tracking Sheet { Y/ n �"U� � _ tL <br /> SPOILS <br /> MATERiALS/D <br /> Storage Method �LOPN ENT <br /> Contamination Noted`'= (y ) Casing type <br /> Storage Location Blank ft: Screen <br /> Slot size <br /> GR_ OLMNG Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios ' l'i3ter Paas typ <br /> fnstalladon Method:i` Surge Block: - y n ) <br /> Quanrity installed Discussed witlx eologist: - C y/ a) <br /> Type of method <br /> EH 29 29 1 <br />