Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: CONSTRUCTION <br /> Premise Address:_ �< 70�(��t��C,��UO_ Total Depth <br /> Screen Length (from) (to) _ <br /> Well No.: /�'��l/ — 3� Filter Pack (from) (to) <br /> Bentonite (from) (to) _ <br /> Inspector: Grout (from) O (to) _ <br /> Drilling rig type <br /> Permit No. Auger O.D. Ste I.D. <br /> Drilling Company: <br /> Completion - ove pip christie box (circle one) <br /> C�e+�'1�� <br /> Driller: 1 (7��'( casing <br /> ��D 2, height Z-s <br /> Consultant_ p / <br /> I T <br /> IT- <br /> Geologist 1> Y�� ( �tJ1�1� <br /> A&J -GROUND <br /> CC MPLEf 1C N CHRlM430X <br /> COMPLETICN <br /> SPECIAL PERMIT INFO. Ground Surtace Q <br /> Distance to sewer line VA- <br /> Domestic well on site - (y/0 (,2 <br /> If yes, location and distance - ft. Lf <br /> ft' <br /> b _ � <br /> = m <br /> SAMPLING aa slotted = c l Z <br /> l axdcn <br /> Holding Temperature _ P <br /> ack <br /> Method = <br /> Screening Method <br /> Tracking Sheet - (y/ n ) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) <br /> Storage Location Casing type <br /> Blank 6G ft. Screen 10 ft. <br /> Slot size 0.010" <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size 3 ':yt'.P <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />