Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: � 6 ) CONSTRUCTION <br /> Premise Address:_ l<T� 5,- N� 411049AR r Total Depth 5 <br /> Well No.: M 1/V - a Screen Length (from) 7 (to) I S <br /> Filter Pack (from) S (to) 1 S <br /> Inspector: J, Bentonite (from) 3 (to) S <br /> Grout (from) 0 (to) 3 <br /> Drilling rig type- 'r 61-5- <br /> Permit No. Auger O.D. F5" I <br /> Drilling Company:_ <br /> Completion - Stove pip christie box ircle one) <br /> Ci4-S��li/ <br /> Driller:_ 0�► `Y casing <br /> height <br /> Consultant rJ K <br /> Geologist s CgW/r"- g-p 7 <br /> ABOVE-GROUND <br /> COMPLETION CNRZ rY-BOX <br /> SPECIAL PERMIT INFO. Grourd Surface COMPLETION <br /> i <br /> Distance to sewer line grout <br /> Domestic well on site - E/ n ) <br /> If yes, location and distance - ft. <br /> = m <br /> SAMPLING , <br /> slotted = 10 <br /> soon <br /> Holding Temperature '— <br /> Method = gm"w Pack <br /> Screening Method —_ <br /> Tracking Sheet - (y/n) _ <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) ,I <br /> Storage Location Casing type_ Z C� • qC7 f Vc�- <br /> Blank '7 ft. Screen S.- <br /> Slot <br /> 'Slot size_ C.0;Z0 K <br /> GROUTING Bags cement_ .1.- <br /> Buckets bentonite I <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size -44- 3 tib <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - 6)n ) <br /> EH 29 29 Type of method <br />