Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: . Sampling Date: 7 r �� <br /> Site: Project No. : <br /> 1 qq II <br /> / Well Designation: tN ate- <br /> � n <br /> Is setup of traff is control devices required? YES time: hours <br /> 1 Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NOIf no, see remarks <br /> Is well cap sealed and locked? NO (M If no, see remarks <br /> Height of well, casing riser (in inches) ': NO; <br /> Well cover type; all UV 12" UV 12" EMCO 8" BK f <br /> 12" BK 1211 DWP_ 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent eve Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> -2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> 1 Sampled with: Disposable bailer:_ Teflon bailer: <br /> Well Diameter; 2" / 411 6+1 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> e s S <br /> Time: ` � Time: Calculated purge: <br /> Depth of well: �� • s � Depth to water: � '3 Actual purge.5� <br /> Depth to water: <br /> Start purge: A- / Sampling time: <br /> Time Temp, L;..C. pH Turbidity Volume <br /> =1 3 <br /> 08 .3 f <br /> Sample appearance: Lock: <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 /> Signature: <br />