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GRA <br /> MONITORING WELL1; <br /> SAMPLING INFORMATION SHEET <br /> Client:_ Project No: <br /> Site; �bgApoWell Designation: M w— (r- <br /> m <br /> Is seWP of traffic control devices repurred? No <br /> r-, ESQ Setup &Takedown trine hours <br /> Is there standing water m well box? syl! I Above TOC Below TOC ) <br /> Is Top of Casing Cut level? NO ( If NO piesse explain in remarks <br /> Is Wali cap sealed and locked? NO ( If NO please explain in remarks) <br /> Height of Well Casing fuser ( m inches) <br /> Generai condition of wellhead assembly • Excailent CGoodFarr Poor (Explain m 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: <br /> Well Diameter: 2" 3" 4" \,L 6" 8" ` <br /> Purge Vol. Mulbpiier 0.163 0.367 0 653 147 2.61 gal/ft <br /> inrual MelgsUirmen Recharae Measurement <br /> Time: 'C j` Time: Calculated purge: <br /> Depth-of well: S-� q3> Depth to water: Actual purge: 2 <br /> Depth to water: 4 � Z - <br /> er Calibration Temp. E.C. pH Turbidity <br /> Date Irgtial reading <br /> Time Adjusted reading <br /> Start purge: S Sampling time: CO Sampling Date: <br /> Time Temp (°F) E.C. pH Turbidity 01(pp-m) Volume (Gal.) <br /> �4- 1 z (_�S o 1 <br /> 14 1 & - 3 -7C,3 - <br /> 1 3 6S <br /> Sample appearance:_ �' kzjod <br /> QC samples collected at this well: Lock: C C1 Oc( <br />(Equipment replaced: (Check all that apply) Note condition of replaced item. � <br /> 2" Locking Cap Lock #2357: , <br /> Lock #0909: ----, <br /> a <br /> 4" Locking Cap: Lock #3753: ,,— Lock-Dolphin: i <br /> Remarks: <br /> Signature Review rte <br />