Exhibit R Well Completion Report.pdf
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- Solicitation number
- ESH_351002_DA
About this file
This is a well completion report form from the Illinois Environmental Protection Agency used to document the technical details of well installation and construction. The form captures comprehensive information about monitoring well installation including site location coordinates, personnel involved (surveyors, contractors, geologists), drilling specifications, and detailed measurements of the well components.
The form requires documentation of critical well construction details including annular space specifications, elevations and depths of various well components (protective casing, riser pipe, screens, etc.), construction materials used (SS304, SS316, PTFE, or PVC options), and installation methods for surface seals, annular sealants, bentonite seals, and sand packs. The form includes a technical diagram showing the typical well construction design and includes fields for recording specific measurements like borehole diameter, riser pipe dimensions, screen lengths, and slot sizes. This appears to be an exhibit document related to a solicitation for installing bedrock monitoring wells at Fermilab's Booster Neutrino Beam facility.
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Text version
Illinois Environmental Protection Agency Well Completion Report
Site Na State Plane C
Well #: _____________
Borehole #: __________
Surve
Drilli
Cons
Drilli
Logg
Repo Comp
AN
WELL CO
Protective C Riser Pipe A Riser Pipe B Screen
Well Comple Site Number: __________________________ County: __________________ me: ___________________________________________________________ o ' " o ' " oordinate: X _____ Y _____ (or) Latitude: ____ ____ ____ Longitude: ____ ____ ____ yed by: ______________________________________ ng Contractor: _________________________________ ulting Firm: ___________________________________ ng Method: ___________________________________ ed By: _______________________________________ rt Form leted By: _____________________________________
IL Registration #: _______________________________
Driller: ________________________________________
Geologist: ______________________________________
Drilling Fluid (Type): _____________________________
Date Started: ____________ Date Finished: ___________
Date: _____________________
NULAR SPACE DETAILS Elevations Depths (.01ft.)
(MSL)* (BGS)
______ _______ Top of Protective Casing
______ _______ Top of Riser Pipe
______ _______ Ground Surface
______ _______ Top of Annular Sealant
Static Water Level ______ _______ (After Completion)
______ _______ Top of Seal
______ _______ Top of Sand Pack
______ _______ Top of Screen
______ _______ Bottom of Screen
______ _______ Bottom of Well
______ _______ Bottom of Borehole
* Referenced to a National Geodetic Datum
CASING MEASURMENTS
Diameter of Borehole (inches) Type of Surface Seal: __________________
Type of Annular Sealant: _______________
Installation Method: _________________
Setting Time: ______________________
Type of Bentonite Seal - - Granular, Pellet, Slurry (Choose One)
Installation Method: _________________
Setting Time: ______________________
Type of Sand Pack: ____________________
Grain Size: _______ (Sieve Size)
Installation Method: ________________
Type of Backfill Material: ______________ (if applicable)
Installation Method: _________________ ID of Riser Pipe (inches) Protective Casing Length (feet) Riser Pipe Length (feet) Bottom of Screen to End Cap (feet) Screen Length (1st slot to last slot) (feet) Total Length of Casing (feet) Screen Slot Size ** **Hand-Slotted Well Screens are Unacceptable
NSTRUCTION MATERIAL
(Choose one type of material for each area) asing SS304, SS316, PTFE, PVC, or Other bove W.T. SS304, SS316, PTFE, PVC, or Other elow W.T. SS304, SS316, PTFE, PVC, or Other
SS304, SS316, PTFE, PVC, or Other tion Form (revised 02/06/02)
| casing: 4 |
| riser-above: 4 |
| riser-below: 4 |
| screen: 4 |
| Site-Number: |
| County: |
| Well-No: |
| Site-Name: |
| Borehole-No: |
| X-Coord: |
| Y-Coord: |
| Lat-Deg: |
| Lat-Min: |
| Lat-Sec: |
| Long-Deg: |
| Long-Min: |
| Long-Sec: |
| Surveyor: |
| Drill-Coord: |
| Consult-Firm: |
| Drill-Method: |
| Logged-by: |
| Completed-By: |
| IL-Registration: |
| Driller: |
| Geologist: |
| Drill-Fluid: |
| Date-Start: |
| Date-Finished: |
| Date: |
| Type-Seal: Concrete |
| Annular-Sealant: Bentonite Slurry |
| Install-Method: Tremie Pipe |
| Set-time: 24 Hours |
| Install-Method2: Poured or Tremie Pipe |
| Set-Time: 1 hour |
| Sand-Type: |
| Grain-Size: 20 |
| Install-Method3: Poured or Tremie Pipe |
| Backfill: N/A |
| Install-Method-Backfill: N/A |
| field1: |
| field2: -3.50 |
| field3: |
| field4: -3 |
| field5: |
| field6: 0 |
| field7: |
| field8: 1 |
| field9: |
| field10: TBD |
| field11: |
| field12: 57.25 |
| field13: |
| field14: 59.25 |
| field15: |
| field16: 61.25 |
| field17: |
| field18: 66.25 |
| field19: |
| field20: 66.5 |
| field21: |
| field22: 67.0 |
| Bore-Diam: 6+ |
| Riser-Pipe: 2 |
| Casing: 60 |
| Pipe-Length: 64.25 |
| Bottom: 0.25 |
| screen-length: 5.0 |
| total: 69.5 |
| screen-slot: 0.010 |
| seal: pellet |
File details come from the government source that posted it. Updated .