Laserfiche WebLink
casing <br />height <br />ABOVE-GROUND <br />COMPLETION <br />ft. <br />Depth to water <br />Mix Ratios <br />Installation Method <br />Quantity Installed <br />EH 29 29 <br />-71i,<,(} <br />MONITORING WELL INSTALLATION REPOA.f <br />Date: CONSTRUCTION <br />Total Depth /51' <br />Screen Length (from) <br />Premise Address: 4// Af • bia/i-Ok6OA3) <br />"b",(4)/1) <br />Drilling Company: <br />Driller: ,IP)7 z-e--00A5 <br />Consultant <br />Geologist • Z---e---c) <br />SPECIAL PERMIT INFO. <br />Distance to sewer line <br />Domestic well on site - n) <br />If yes, location and distance - 2-00 <br />• <br />SAMPLING <br />Holding Temperature <br />Method <br />'cl - <br />C <br />i C ____ <br />Screening Method <br />Tracking Sheet ( y ) <br />SPOILS <br />(to) <br />Filter Pack (from) (to) <br />Bentonite (from) (to) 4.3 <br />Grout (from) (to) 6 <br />Drilling rig type <br />Auger 0.D. I.D. <br />Completion - Stove pipe/christie box (circle one) <br />Well No.: <br />Inspector: <br />Permit No. <br />Storage Method S'S S-rts-f <br />Contamination Noted - CastrLiic <br />Storage Location <br />6ea.a) <br />GROUTINGGROUTING <br />MATERIALS/DEVELOPMENT t/a <br />Casing type <br />Buckets bentonite affe (7-k 36) Bags cement <br />Bags sand/gravel <br />Filter Pack type/size <br />Surge Block: - ( y / n) <br />Discussed with geologist: - ( y / n) <br />Type of method <br />• <br />Blank /54- ft. Screen 5 ft. <br />slot size ,OL-6)