Laserfiche WebLink
DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client Sampling Date <br /> Site /,eC r s Project No <br /> � Well Designation w <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NO if no,see remarks <br /> Is well cap sealed and locked2 NO If no,see remarks <br /> Height of well casing riser(in inches) <br /> Well cover type 8" or 12" UV 12"EMCO_ 8"or 12"BK 8" Christy <br /> j 12" Chnsty 8"M&D 12"M&D 12"DWP <br /> 12" CNl 36" CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Goad Fair Poor <br /> Purging Equipment 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer _Centnfugal pump <br /> Sampled with Disposable bailer >e-__ Teflon bailer Disposable Tubing <br /> 1 Well Diameter 2" X 4" 6" 8" <br /> 1 <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time I I 3 0 Time 0: /'�' Calculated purge <br /> .Depth of well f' Depth to water Actual purge <br />' Depth to water ? - <br /> 1 <br /> I <br /> Startpurge I o ' / d Sampling time /49 s l it�' <br /> Time Temperature EC pH Turbidity Volume <br /> e , <br /> io i 3 0 - t of 3 5� o Z 3 <br /> Sample appearance ( Lock Equipment replaced (check all that apply}' Note condition of replaced item(s) <br /> 2" Locking Cap LocW �/jla Allenhead <br /> VT <br /> 4" Locking Cap Lock-Dolphin r 9/16 Bolt <br /> 6" Locking Cap Pinned Allenhead (DWP) <br /> Oemarks t <br /> Signature <br /> f t� . <br />