Laserfiche WebLink
GRG <br /> MONrrORnv I i <br /> G WELL SAMPLING INFDRMATION SHEET <br /> Client: Project No: <br /> Site:_'��r 5 �L JbkAbD Well Designation: Y71v,1— c _ <br /> TaAl r-A <br /> Is setup of traffic control devices required? 4 ' YES Setup &Takedown time: hogs <br /> Is there standing water in well box? NO YES (Above TOC Baiow TOC ) <br /> Is Top of Casing cut level? NO ( If NO please explmn m remarks) <br /> Is well cap senied and locked? NO ES) ( if NO please explaan in remarks) <br /> Height of Well Casing Riser ( in inches) <br /> General condition of Wellhead assembly Excellentood� Fear Poor (Explain in remarks) <br /> Purging Equipment: 2" Disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer <br /> Sampled with: Disposal bailer: Teflon Bailer: 7-- <br /> Well Diameter: 2" 3" 4" 6" 8" <br /> Purge Vol. Multiplier 0 163 0.367 0.663 147 2.61 gal/ft <br /> Innial Measurment R&Gbilrue_Measurement <br /> Timer Time: 1 Calculated purge: `j10 <br /> Depth of well: �q C{ Depth to water. �N-4 a1 Actual purge:. , (J <br />*Depth to water: 4-4 Zper Calibration Temp. E.C. pH Turbidity <br /> o Initial reading <br /> Time Adjusted reading <br /> Start purge: 13 2Z Sampling time: � S __)�S Sampling Date: <br /> Time Temp (OF) E.C. pH Turbidity O=(ppm) Volume (Gal.) <br /> ti ;31 _,s' 7 3 o,s -7 65 I * 1 1, <br /> 17,3 q 6 Z "7 (.o , <br /> `3 4-0 �oC o -7-7 '7 69 N% <br /> Sample appearance: rr <br /> QC samples collected at this well: Lock: ['C <br /> Equipment replaced: (Check all that apply) Note condition of replaced item. <br /> 2" Locking Cap: Lock #2357: , <br /> Lock #0909: _ <br /> 4" Locking Cap: Lock #3753: Lock-Dolphin: <br /> Remarks: <br /> Signature ���,,n (�� _. Review /l, <br />