GFI-4.pdf

Date:

Driller's Name:

Borehole Logger's Name:

COR(s):

Hole Diameter (in):

Actual Depth of VB Hole (ft)1:

CT #:

AT #:

Depth Min. (ft) Max. (ft) Run QA QC

Top 1/3

Middle 2/3

Bottom 3/3

Date: Date:

Depth: Depth:

OPTV CCTV

Northing:

Bottom of Wall (EL):

Run (ft)

Core Sample Depth (ft.)Core Samples Locations Ranges (ft)

Top of Wall (EL):

Ground Elevation (ft):

Station:

Easting:

Center of Panel, Overlap, or Joint:

Panel Completion Date:

Panel Number(s):

Verification Boring Number:

Mechanical Breaks Depths (ft.)3

Pits, Vugs, Rod drops, Water Loss, Change in drill water color, etc.)

Planned Depth of VB Hole (ft):

Depth to Bottom of Wall (ft):

Depth to Top of Wall (ft):

Descriptions

Decommisioned Date:

Saturation of Borehole

Falling Head Test

End Date, Time, Water Depth (ft):

Start Date, Time, Water Depth (ft):

Start Time:

Easting:Total Vector Deviation: Northing:

RQD Rec.

Drill Time

End Time:

Start Time:

Verification Drilling and Field Permeability Testing QA Form

Automatic Cutoff Wall Reading2:

Manual Cutoff Wall Reading:

Manual Water Depth (top of casing) at End (ft):

Manual Water Depth (top of casing) at Start (ft):

End Date & Time:

Start Date & Time:

End Time: