Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: .f9— Sampling Date;_� � � <br /> Site: a izC a 13 0 Project No. : <br /> Z9a6 N )" Well Designation: J <br /> Is setup of traffic control devices required7 kftD YES time: hours <br /> Is there standing water in well box? 0 YES Above TOC Below TOC <br /> Is top of casing cut levels NO <M If no, see remarks <br /> Is well cap sealed and locked' N(S YE If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" LTV_ 12" EMCO 8" BK <br /> 12" BK 121" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent <:T�_ 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: ✓r57e Teflon bailer <br /> t Well Diameter: 2" 4" /\ 6" 8" <br /> , <br /> i <br /> t Purge Vol . Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> i Initial Measurement Recharge Measurement <br /> Time : `( 2- 6 Time: Calculated purge: s <br /> Depth of well : 3 Depth to water: t� s- �� Actual purge:_'5 <br /> Depth to water: q4 3 44 <br /> i <br /> Start purge: 6 S Sampling time: 6 3 Q <br /> Time Temp. E. C. pH Turbidity Volume <br /> Sample appearance: _ t Lock: ! S �-- <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock , 3753 ; 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt : <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> i <br /> Remarks: <br /> Signature <br />