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DOUL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: sampling Date: 3_.LJ� <br /> Site: dR e- " 6 qb - Project No. : -60. <br />. 10o S- C49 22t� Well Designation: AW- 1:2 <br /> C <br /> Is set•:p of traffic control devices required? YES time: hours <br /> Is here standing water in well box? YES Above TQC Below TOC <br /> Is top of casing cut level? N E If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : a <br /> Well cover type: 811 UV 1211 W 1211 EMCO 8 90 BK <br /> 12" BK 12" DWP 1240 CNI � 3600 CNI then <br /> General condition of wellhead assembly: Excellent ( 0o Fair Poor <br /> Purging Equipment: 211 disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4f1 PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer:-)( Teflon bailer: x <br /> Well Diameter: 2" 401 6" 800 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: !1- a 1 Time: ape f 1 Calculated purge: <br /> Depth of well: 6r, � Depth to water: ''�- f Actual purge: a. � <br /> Depth to water: 6 C. ' <br /> Start purge: L1 ? Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1 _� /C) LP)q <br /> 0-7 <br /> 1'5Cf J <br /> Sample appearance: Lock: --� <br /> Equipment replaced: (Check all that apply) Nome condition of replaced item <br /> 2" Locking Cap: Lock 93753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock.-Dolphin: 9/16 Boit: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> i <br /> Signature: 11211 lLnQ �4 <br />