Laserfiche WebLink
PIP& 4-- <br />W otj- QUA 11-P <br />[8523 <br />W?u. rs-i-,;?tVZ QA/4C Form <br />Well Desig ation_MW -1604 <br />Date t0 23 <br />Inspector . L. ,arse <br />Page 2 of 5 <br />2) Source of any water used for drilling: <br />_SGF}WPga: UjAtVE2 R 1,.v- +?'G?tZ: T2 R'Itit??7U7 ?LS41t17' <br />3) Name of any chemical additives or muds used: <br />!V o u c cd,s zD <br />C. Size and depth. of well bore hole, type of. drilling <br />1) Method used to drill well bore hole? <br />2) Nominal hole size? <br />3) Type of drilling used tR Z,O 2s! Oi4m mc?z. <br />Drilled depth of hole?. s" <br />D. Piezometer casing and screen <br />Well casing and screen specifications. <br />a. Type of well casing and screen used? -PVG-F(-ust4J.CtN?- <br />Reason other than PVC casing and screen with.screw joints <br />:was used:. <br />3 ,ioCA+s soli <br />30? <br />- G••s:r ' <br />z3-xTV <br />b. Nominal diameter of.casing-and screen used? .'; <br />Reason for variation from minimum 2 inch nominal <br />diameter: <br />-PLAnl C u-Ep Fog u <br />2) Installation 5e-p-e SLO-r S (U •,fs 0,?3 riucf/ <br />a. Length of screen installed? 5'0' <br />Reason for variation from specified screen interval <br />b. Total length of casing-installed? ' <br />joints used? 3 ,2'a•4s Number of <br />Was sufficient casing installed to reach from total depth <br />of hole to within one foot of top of surface casing? <br />Yes ,/ No .Reason for variation: ?m