Laserfiche WebLink
JE OF <br /> MONITORING WELL INSTALLATION REPORT <br /> i <br /> Date: Z rl D CONSTRUCTION <br /> Premise Address: 27� GJ�s�l�f � Well No. <br /> inspector: Total Depth <br /> Screen Length <br /> Filter Pack <br /> Bentonite Pellets <br /> Permit No. U - 3 Z y y Grout <br /> Consultant / L Completion-Stove pipe/christie box <br /> Geologist- r-/its e <br /> Auger O.D. <br /> Auger I.D. <br /> SAMPLING <br /> stldc•up <br /> Holding TemperatureT <br /> Method T <br /> T <br /> Screening Method <br /> ABOVE-GROUND CHRISTY-BOX <br /> Tracking Sheet (y/n) COMPLETION COMPLETION <br /> Ground Surface <br /> SPOILS <br /> grout <br /> Storage Method <br /> Contamination Noted - yes/no ft. <br /> Storage Location __ft. <br /> a <br /> SPECIAL PERMIT INFO. = c <br /> slotted = c <br /> Distance to sewer line section <br /> Domestic well on site - yes/no = yravWpack <br /> If yes, location & distance - <br /> GROUTING <br /> MATERIALS USED: <br /> Depth to water Casing type <br /> Mix Ratios Blank ft. Screen ft. <br /> Installation Method Slot size <br /> Quantity Installed Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel <br /> Filter Pack type/size <br /> Total Billed Time Per Site <br /> Date Permit Finalized <br />