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A== � SAMPLING: INFORMATION, SHEET' <br /> l O 4 <br /> Client: Project No: 5 Z- <br /> Site: I Q 0- Well Designation: GQul- <br /> a <br /> Is setup of traffic control devices regkdredl Setup <br /> YES &Takedown time: haus <br /> to there standing water in wall box7 YES (Above TOC Balaw TOC ) <br /> Is Top of Casing cut level? NO 4%9 (If NO please explain In reemarksl <br /> Is wed cap sealed and locked? NO to (If NO please explain In nmurlksl <br /> Height of Wail Caskng Riser( In inched 46 <br /> General condition of Wadhaad assembly Exceitsnt Good L ^ Far (Explain in namartcsI <br /> Purging Equipment: 2" Disposable bailer X Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer <br /> Sampled with: Disposal bailer: =, Teflon Bailer: <br /> Well Diameter: 2" _ 3" _ 4" 6" 8" <br /> Purge Vol. Multiplier: 0.163 0.367 0.653 `` 1.47 2.61 galift. <br /> Initial Mes ly' Recharge Measu[gmr,0l <br /> Time: 07 ,� 3r� Time: Calculated purge: w �� <br /> Depth of well: - Depth to vdater: / Actual purge: RZ <br /> Depth to water: GAS YS <br /> Meter Calibration Temp. E.C. pH Turbidity <br /> e initial reeding <br /> [me AdjMad mading <br /> Start purge: 1' t Id, Sampling. time: Sampling Date: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 13 -o2 P-3 -7 3` -7 . s i 7 <br /> Sample appearance: <br /> Ago t Pere <br /> QC samples collected at this well: Lack: <br /> Equipment replaced: (Check all that apply) Note condition of replaced atom. <br /> 2" Locking Cap: bock #2357. dock #0909: 0 <br /> 4" Locking Cap: n Lock #3753: sock-Dolphin: <br /> Remarks: t3 �' ('i - W t3 go, `/ N ��0 - a " K <br /> ?YX, W <br /> Signature Review <br />