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DOULOS ENVTROMMENTAL COMPANY SAMPLING WFORMATION SHEET <br /> Client Ultramar Sampling Date -Z 7-q <br /> Set B"mn#695 Project No 94-695-01 <br /> 900 aguth Cherrokgs Lm Well Designation ASW- 1.+1 <br /> 14dL CA <br /> Is setup of traffic control devices required? O YES time hours <br /> Is there atanding water in well box? YES Above TOC Below TOC <br /> Is top of casing cut kwt? NO S If no,we remarks <br /> Is well cap sealed and locked? NO If no,m remaalm <br /> Height of well casing rs=(m inches) r <br /> Well cover type 8"UV 12"UV 12"EMCO 8"BK <br /> 12"BK 12"DPW _ l2"CNI 36"CNI Other <br /> General conditionof wellhead assembly Excegent Farr Pool' <br /> Purging Equipment 2"disposable bailer Submersible pump <br /> 3" PVC bailer Dodwated barter <br /> 4"PVC baler _Centrtfugal pump <br /> Sampled with Disposable bailer Teflon bailer <br /> Well diameter 2" .-� 4" 61 8" <br /> Purge VoL Multiplier 016 065 147 2.61 SAM <br /> Initial MRmhorm <br /> Tana 11)_6 Tuna 81 -- Cakulated purE <br /> Dapth of wA Dapth to WCtar no `P Act"purges �. •�• <br /> Depth to wc=r A 6 2-- <br /> Start purge /0 Sampling time <br /> Time Temperatuars E. C. pH Tu bidtty Volume <br /> /0 <br /> Sample appearaaoe Lock <br /> Equipment replaced. (Cheat all that apply) Note coasditiaa of replaced itww <br /> 20 Nckmg cap Lash 03753 7/32 Allenhm� <br /> 40 locking cap Lash-Dolphin 9/16 bo1L <br /> 6"kAmg cap Punned Allenh (DPW <br /> Remarks. <br /> Signature <br /> t <br />