Laserfiche WebLink
MONITORING WELL INSTALLATION REF- ecT <br /> Dale: II,—,,=OT— CONSTRUCI70N <br /> ?remise Address: /01 IA): <br /> A): Tota! Depth <br /> M q Screen Length (from) C[o) <br /> Well No.: w Filter ire (from) :Z ([o)� <br /> ` Bentonite (from) (to) <br /> �f OAJ Grout (from) Cto) <br /> inspector. <br /> Drilling rig type <br /> Auger O.D. [�• <br /> Permit No._ Completion - Sto a pipe/christie box (circle one) <br /> Drilling ComoanT:� <br /> casiaq <br /> Driller. he_ghc <br /> Consultant <br /> �Tl <br /> W <br /> Geologist '� yE„gWNO <br /> C7-A15�!-30X <br /> CC, , '=L ICN CJMPI--i ICN <br /> C'o nd sufr <br /> SPECIAL PERMIT INFO. <br /> � groc.•t <br /> Distance to sewer line <br /> Domestic well on site - ( y/ n ) <br /> If yes, location and distance <br /> h. <br /> e <br /> 0 <br /> tbRad � `a <br /> SAMPLING <br /> Holding Temperature = `i <br /> Method ' <br /> Screening Method - <br /> Tracking Sheer - C y/ n ) _ tt <br /> SPOILS <br /> Storage Method MATEMALS/DEVHLOPMENT <br /> Contamination Noted - (y/ n ) Casing type Ut` <br /> Storage Location Blank fr- Screen h <br /> Slot size <br /> TING J Bags cern <br /> GROUent <br /> Buckets bentonite <br /> Bags sand/gtavel <br /> Depth to water Filter Pack type/size <br /> Mix Ratios ( [ Surge Block: - (y/ n ) <br /> installation Method J Discussed with geologist - C y <br /> Quantity Installed Type of method <br /> EH 29 29 <br />