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_ G_RC3 <br /> MONITORING WELL SA-MPLING INFORMATION SHEET <br /> Client:T xA,cD : �6 /7Wj4V5,yrR7- Project No: 9&z4;7- 00/ <br /> Site: �tw�t/ C,y7'r?�2�SCS Well Designation: �;L L-L �– <br /> Q Cf1. <br /> Is setup of traffic control devices required? ( N0,_ YES Setup &Takedown time: hours <br /> Is there standing water in well box? ND YES ( Above TOC Below TOC 1 <br /> Is Top of Casing cut level? NO AYES- ( If NO please axplain in remarks) <br /> Is wed cap sealed and locked? NO YES ( If NO please explain in remarks) <br /> Height of Well Casing Riser ( in inches► <br /> General condition of WaMead assembiv Excellent Good Fair Poor (Explain in remarks) <br /> Purging Equipment: 2" Disposable bailer Submersible pump <br /> _2" PVC bailer Dedicated bailer <br /> 4" PVC bailer <br /> Sampled with: Disposal bailer: (M-11 ' Teflon Bailer: Q <br /> Well Diameter. 2" 3" _ 4" — 6" _ 81• <br /> Purge Vol. Multiplier: 0.163 0.367 0.663 1.47 2.61 gal/ft. <br /> Initial Measurment Recharge Measurement <br /> T1me:C Time: Calculated purge: 1 < <br /> pth of well: Depth to water: Actual purge: <br /> epth to water: - S <br /> Start purge:;✓F3 Sampling time: otss Sampling Date: <br /> Time ITemp ( F) E.C. pH Turbidity OZ (ppm) Volume (Gal.) <br /> I <br /> Sampie,sppearance: <br /> QC samples collected at this well: <br /> v,J - Lock: f. <br /> _ t <br /> Equipment replaced: (Check ail that apply) Note condition & repiaced item. <br /> 2" Locking Cap: ❑ Lock i#2357: ❑ Lock #0909: Q <br /> 3" Locking Cap: 7 Lock :3753:1:3 Lock-Dolphin:F7 <br /> 4" Locking Cap: r7 Chevron Lock: r7 <br /> Remarks: <br /> r <br /> Signature Review <br />