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10/05/2000 05 35 9167629054 DOULOS PAGE 05 <br /> I <br /> DOULOS ENVIRO ENTAL COMPANY INFOFMATION SHEET <br /> Client: Sampling Date: iL Lt--co <br /> site; ! Project No. <br /> -k- Well Designation: A <br /> Is setup of trafffc. control devices required? YES time: hours <br /> Is there standir# water in well box? N YES Above TOG Below TOC <br /> Is top of casingicut level? � if no, see remarks <br /> Is well cap seal d and locked? NO if no, see remarks <br /> Height of well 'sing riser (in inches) : '4 <br /> Well Cover type: 81, W 12" W 12" EMCO 8" HK <br /> 12" BK 12" DWF_12" CNI_ 36" CNI other /1-.MY-4 <br /> General conditio„c,C wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment 2” disposable bailer submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 410 PVC bailerCentrifugal pump <br /> Sampled witi . Disposable bailer: Teflon bailer: <br /> Well Dia�eter: 2"4— 4** 6+1 Sol <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2 . 61 gal/ft. <br /> Initial Meas rem nt Recharge Heagurement <br /> Times: _ W.)- Time; 410 Calculated purge: <br /> Depth of well :—. Depth to water: IVA Actual purge:_-L-n <br /> Depth to water: <br /> Start purge: Sampling timer <br /> Timeemp E.C. pH Turbidity Volume <br /> Sample appea ance: Lock: <br /> Equipment replace • (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap. _ _ Lock 03793 : 7/32 Allenhead: <br /> 4" Locking Cap. J­ Lock--Dolphin: 4 9/16 Bolt: <br /> 6" Locking Cap _ Pinned Allenhead (DWP) : <br /> • i T <br /> Remarks: f— � 1 F ,ei i <br /> r <br /> � t <br /> Signature: ��. <br />