Laserfiche WebLink
�' ONITORING WELL INSTALLATION REPT <br /> Date:—p ✓ O CONSTRUCTION <br /> Premise Address: !l)� S �'1 L � Total Depth 75 �✓ . <br /> 5Screen Length (from) 7U (to) �d <br /> Well No.: Filter Pack (from) 8 (to) S <br /> ^/ J/ Bentonite (from) GG (to) G� <br /> Inspector: Grout (from) (to) 4e <br /> Drilling rig type <br /> Permit No. !/ Z 3 2 O Auger O.D. 91" I.D. <br /> Completions- Stove pipe/christie box (circle one) <br /> Drilling Company: f� �ti �k �l�o!✓./ u<l ��> <br /> Driller: 4 casing l' <br /> height <br /> Consultant ° i`" "`"`- S <br /> -1EW-f <br /> Geologist '31-GW <br /> ABOVE-GROUND CHS*7Y-aOX <br /> OOWLE ION COMPLE71CN <br /> SPECIAL PERMIT INFO. Ground S"di09 <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n) ft. <br /> If yes, location and distance - ft. <br /> ft. <br /> — a <br /> = m <br /> 0 <br /> — o <br /> SAMPLING dotted = S <br /> &#don — <br /> Holding Temperature <br /> Method Ll <br /> Screening Methodgn" <br /> Tracking Sheet - (y/ ntt. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n) I>VC <br /> Storage Location Casing type <br /> Blank 76) ft. Screen_"_ <br /> Slot size Ua49 <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/s' e <br /> Installation Method Surge Block: - (& n) <br /> Quantity Installed Discussed with geologist: - (y/ n) <br /> Type of method <br /> EH 29 29 <br />