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D0UL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> • Client: Sampling Date: <br /> Site: . �0•� _ Project No. : <br /> Lqk-�_C /Q� Well Designation: MW-3 <br /> )` <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? If no, see remarks <br /> Is well cap sealed and locked? NO YYn If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 1211 CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent SLOY 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: <br /> _--k— Teflon bailer: <br /> Well Diameter: 2" -) 411 611 811 <br /> I . Purge Vol . Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial MeAsurementRecharge Measurement <br /> Time; 1 Time: 10,76 Calculated purge. S"5 <br /> Depth of well: 1-0.fq Depth to water: goo Actual purge: 5.r � <br /> Depth to water: t 6 <br /> start purge: 1630 Sampling time: 1037 <br /> 1 ' <br /> Time Temp. E. C. pH Turbidity Volume <br /> 62 /z10 Z/0 - l <br /> /DJ6 )-, 2 t s7 705 �- 3 <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 /> r 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks : <br /> qzJ V_ <br /> Signature: <br />