Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> y <br /> Client: // Sampling Date• 6` <br /> S1te • 2-1 FO Project No. : <br /> Well Designation. Mw- <br /> Is setup of traffic control devices required'; N YES time: hours <br /> Is there standing water .in well box' O S Above TOC Below TOC <br /> Is top of casing cut lever Y If no, see remarks <br /> Is well cap sealed and locked? NO S If no, see remarks <br /> Height of well casing riser (in inches) - fd <br /> Well cover type ' 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 1.2" DWP 12" CNI 36" CNI C77Rthea__ — <br /> General condition of wellhead assembly: Excellent oo Fair P or <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with. Disposal bailer: Teflon bailer: <br /> Well Diameter 2" 41' 611 8TI <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1 . 47 2 . 61 gal/ft . <br /> Initial Measurement Recharge Measurement <br /> Time ' <br /> Time:1 !�j Calculated purge: <br /> eciAlt7wepth of we 1 4 Depth to water. Actual purge , <br /> epth to water. <br /> Start purge . Sampling time: ' 2 <br /> Time Temp. E. C. pH Turbidity Volume <br /> lei i� 3 <br /> 6 .3 <br /> Sample appearance. Lock <br /> Equipment replaced- (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap- Lock #3753 : 7/32 Allenhead - <br /> 4 " Locking Cap: Lock-Dolphin: 9/16 Bolt - <br /> 611 Locking Cap Pinned Allenhead (DWP) : <br /> Remarks . <br /> Signature: <br />