Laserfiche WebLink
DOULOS ENVIRONMENTAL COKPANY SAMPLING INFORMATION SHEET <br /> Client: ,�� �,, Sampling Date: <br /> Site: r <br /> M C Project No, : qq <br /> PO -IQn Rai Well Designation: <br /> Z_92!� LWj. .LA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV12" W 12' EMCO ,$" BK <br /> 12" BK 1.211 DWP 12" CNY 36" CNI Other d M 4r 1�?_ / <br /> General condition of wellhead assembly: Excellent 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: � Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1 . 47 2 . 61 gal/ft. <br /> 1 • Time:__IV Time: = Calculated purge <br /> Depth of well: '0 3 Depth to water: Actual purge.� <br /> Depth to water: <br /> Start purge: 1 10 Sampling time: 1 <br /> 1 <br /> Time Temp., E.C. pH Turbidity Volume <br /> IL ? 0 <br /> -7 °' 4 3 r '9 <br /> i <br /> Sample appearance: Lock: IDel�- <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 /> Remarks; <br /> I <br /> Signature: <br />