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DOUL08 ENVIRONMENTAL COMPANY INFORMATION HEET <br /> Client:.. <br /> Sampling Date: <br /> Site Project No. : <br /> Well Designation: e <br /> Is setup of traffic control devices required? 0 YES time : hours <br /> Is there standing water in 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 locked? NO E If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8'" UV 12" W 12" EMCO 8" BK <br /> 12" BK 12 " DWP 12" CNI 36" CNI ther))/'r?_}+1�� <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailer _Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> Well Diameter: 2" 4" 611 gu <br /> Purge Vol. Multiplier: 0 . 16 0 . 65 1. 47 2 . 61. gal/ft. <br /> ,In ' t ' al Measurement Recharge Measurement <br /> Time :_ 'Lilf- Time: IK_4Calculated purge. 60.�- <br /> Depth of well : �-� Depth to water: 2 2, 5T 4 Actual purge • 60,2- 1 <br /> Depth to water• "-)- <br /> Start purge: /6 3b Sampling time: / 61�!� <br /> Time Temp. E. C. pH Turbidity Volume <br /> 1163 4 1 21,3 <br /> /640 -70 2- P-D0 -7Z/ <br /> 2, <br /> 16415 703 -3 90 7 3 <br /> Sample appearance: �� Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt , <br /> 61' Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> c <br /> Signature : <br />