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. DOULOS ENVIRONMEN''.C'AL COMPANY SAMPL_' 14 - INFORMATION SHEET <br /> lnc�— Sampling Date <br /> 96— <br /> �"-�d <br /> Client: <br /> Sit., + r Project no <br /> Well Designat_on W <br /> Is setup of traffic control devices required? , __ YEa time: hours <br /> Is there standing water in well box? N Y S Above TOC Below TOC <br /> Is top of PAsing cut level? No E If no, see remarks <br /> Is well cap sealed and locked? No W It no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 6" UV � 12" UV 12" EMC0__ 8'} BK <br /> 12" BK_ 12" DWP /12�"$CNI X 36" CNI f,ther <br /> General condition of weIlhea assembly; Excellent °01 Fair poor <br /> Purging Equipment: 211 disposable bailer __Submersible pump <br /> 2" PVC bailer _ Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:.ff. Teflon bailer <br /> Well Diameter: 2" 4'f_06" 8" <br /> 4 <br /> Purge Vol. Multiplier: 0. 16 0.65 1 47 61 gal/ft. <br /> Initial .;.,I&a 42 11'p-my" nt Recharge measurement Time <br /> 'Time: Time: Calculated purge: 61 T / <br /> Depth of well: 7t ' y 1 Depth to water; 3 ` b Actual purge.r�7 <br /> Depth to water: <br /> start purge:,^ Sampling time: <br /> ' Time Temp. E. C. pH Turbidity Volume <br /> 0 73 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead:� <br /> 4" Locking Cap: Lock-Dolphin:_ 9/1.6 Bolt- <br /> 6" Locking Cap: Pinned Alienhead (DWP) : <br /> Remarks: <br /> Signature: <br /> VO 30vd so-inoQ b506Z8L916 8b 50 000Z/t T/80 <br />