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r <br /> GRO <br /> MONUORING WELL SAMPLING INFORMATION SHEET I= <br /> MOON <br /> i <br /> Client: _ Project No: <br /> Site: bpkAbo Well Designation: <br /> Ta <br /> Is setup of traffic controi devices required? NO ESJ ` Situp &Takedown time: hours <br /> Is there standing water in well box? YES ( Above TOC Below TOC } <br /> r Is Top of Casmg cut leval7 NO I If NO please explain in remarks) <br /> Is well cep sealed and locked? NO ( If NO please explain in remarks) <br /> Height of Wap Casing Risar( m inches) <br /> General candhion of Wellhead assembly Excellent ood Fair poor (Exalam 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. -7- Teflon Bailer: 7-- <br /> Well Diameter: 2" 3" _ 4" X 6" <br /> Purge Vol. Multiplier* 0.163 0.367 0.653 147 2.61 galift. <br /> _IrMal Measurment _ftharae Measurement <br /> Tirne: l n C)5� Time: 14-4-S Calculated purge: <br /> Depth of well: '!�6i Depth to water Ar Z Actual purge: c <br /> Depth to water.4-4 C r� <br /> er Calibration Temp. E.C. pH Turbidity <br /> Date Init,ai reading <br /> Time Adjusted reading <br /> Start purge: 1 aS Sampling time: Sampling Date: l t— <br /> ,Time Temp FF) E.C. pH Turbidity Or,(Ppm) Volume (Gal.) <br /> Sample appearance: C.�c,(j <br /> QC samples collected at this well: - Lock: CC{(:)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 13753: ,— Lock-Dolphin:—I <br /> Remarks: L4 nC-7 a V(a�1G bye <br /> r <br /> 5 <br /> Signature alc_w_ v�,T� Review Gtr <br />