Laserfiche WebLink
a <br /> DOULOS ENVZRONKEli'!,AL COHPUY - SAMPLINQ INFORMATION SHEET <br /> Client: , Sampling Date-. ,Z l0 -d Z <br /> Site ; rProject No. ; <br /> IV -AXd <br /> / P01,144tl Well Designation: <br /> 1 Is setup of traffic control devices required? YAS time: hours <br /> Is there standing water in well box? NO Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NOIf no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV_ 1211 UV12" EMCO 8'i BK <br /> 1 1211 8K 1211 DWP 1211 CNI 36" CHI then �K.�� <br /> General condition of wellhead assembly: Excellent o Fair Poor <br /> Purging Equipment: 211 disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 1 4" PVC bailer _Centrifugal pump <br /> Sampled with: Disposable bailer:_ Teflon bailer: <br /> Well Diameter: 20,' _ 411611 8" <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1. 47 2 . 61. gal/ft <br /> I <br /> Time : Times Calculated purge: <br /> Depth of well : 9 Depth to water:,.ZQ.!'.S Actual purge . <br /> Depth to water: <br /> '� <br />'T start purge : � Sampling time: � O <br /> P <br /> Time Temp... E.C. pH Turbidity Volume <br /> � .'22 <br /> r :-23 1 <br /> 2 r• �oS" ______ <br /> i <br /> f <br /> Sample appearance: Lock: h llV <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock #3753 ; 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin; 9/16 Bolt: <br /> 611 Locking Cap: PinneeAllenhead (DWP <br /> Remarks : <br /> signature : �" 14 <br />