Laserfiche WebLink
MONITORING WELL INSTALLATION REPO <br /> t <br /> t <br /> Date:6A7 CONSTRUCTION <br /> Premise Address: Total Depth qd <br /> Screen Length (from) (to) <br /> Well No. j 3 Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit No. 01 Z Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company:_ <br /> Driller: cas ing <br /> height <br /> Consultant <br /> Geologist •— <br /> ABOVE-GROUND CHRM'Y BOX <br /> COM?LETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surf <br /> Distance to sewer line of0A <br /> Domestic well on site - (y/n ) <br /> ft• <br /> if yes, location and distance - <br /> .rA O <br /> SAMPLING sEonod <br /> &ecdon _ <br /> Holding TemperatureVAYW f: P <br /> Method _ <br /> Screening Method <br /> .h = <br /> Tracking Sheet - (y/ n) `4. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) �� U <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water ! Bags sand/gravel <br /> Mix Ratios/In.r a" „__ Filter Pack type/size <br /> i Installation Method j/Lj � Surge Block: - (y/ n ) <br /> I Quantity Installed 7 Mia .jet- ___ Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />