Laserfiche WebLink
MONITORING WELL INSTALLATION REPOn f <br /> Date: �" �`l- �1 CONSTRUCTION <br /> Premise Address: Z o Total Depth I <br /> Screen Length (from) I 'S (to) ((M <br /> Well No.: ^y ' Filter Pack (from) ils (to) a •G <br /> Bentonite (from) ei 1 - (to) `lo" <br /> Inspector: aW 6 Grout (from) el L (to) k <br /> Drilling rig type P-) -�,q 1 <br /> Permit No. Auger O.D. �,' � I.D. <br /> C��Z Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: iC, <br /> Driller: TI_Ey�,V)z casing <br /> height /_ <br /> Consultant f}5 <br /> Geologist2� iz i 1L L <br /> ABOVE-GACUND � <br /> COMPLETION OMPLE N <br /> SPECIAL PERMIT INFO. Ground Sumacs <br /> Distance to sever lirw <br /> 14 0(out <br /> Domestic ell on site - / n) ft. <br /> If yes, loca st ce - <br /> I'v <br /> SAMPLING <br /> •tot:A.i <br /> sscicn = — <br /> Holding Temperature 4 u(,, <br /> Method ttSA = �avwF <br /> ack <br /> Screening Method — <br /> Tracking Sheet y n ) - C ,4 <br /> SPOILS n <br /> Storage Method N - t MATERIALS/DEVELOPMENT <br /> Contamination Noted - y/n ) - ro rA) <br /> Storage Location F1, k PAi"V r?; Casing type .5 t 60 QUG Z <br /> Blank ft. Screen <br /> Slot size 0. 029 <br /> GROUTING ent <br /> Buc cntonite <br /> Depth to water a s s gravel 5 <br /> Mix Ratios Filter Pack type/ ' e_ 2T!Z <br /> Installation Method Surge Block: - n ) <br /> Quantity Installed Discussed with geolo�,ist: - y/ n ) <br /> Type of mcdiod tfilLL .Yl. <br /> EH 29 29 <br />