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10/11/2000 13 38 9167829054 DOULOS PAGE 06 <br /> DOUL08 ENVIAONXE MAL COIMMY SAMPLING INFORl'JATION SHEET <br /> Client- <br /> Sampling Date: R` 2-0 Q� <br /> site:. 1A1.L P1A5A&. Project No. : <br /> 1n Well Designation: V 2- <br /> Is setup of traffic control devices required? V YES time: hours <br /> Is there standing water in well box? fa YES Above TOC Below TOC <br /> Is top of casing _ut level? Ro It no, see remarks <br /> Is well cap sealed and locked? N If no, see remarks <br /> Height of well casing riser (in inches) : <br /> well cover type. 8" W 12" UV 12" EMCO <br /> 12" BK 14-11 OWP 12" CNI� 3610 CNI her <br /> General condition of wellhead assembly: Excellent iEqo Fair Poor <br /> Purging Equipmve-t 2" disposable bailer submersible pump <br /> 211 PVC bailer Dedicated bailer <br /> 4" PVC bailer _.Centrifugal pump <br /> Sampled with Disposable bailer:,, Teflon bailer: <br /> Well Diameter: 2",4 4" 6" S" <br /> ,Purge vol. Multiplier: 0. 16 0. 65 1,47 2.61 gal/ft. <br /> Initial P easur_emen—t Recbgrge Neasureme <br /> Time: - ID I Time; Calculated purg <br /> e: <br /> Depth of wei _ { -f Depth to water: Actual purge:.CLI .11- <br /> Depth to water. <br /> Start purge: /12# _ sampling time: f <br /> Time Temp, E.C. pH Turbidity volume <br /> 111.5 <br /> hL4 t /766 7 5 �. <br /> 1 1)ir7 E17 E 6 6"! <br /> r Semple 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: / : <br /> 6" Locking Cal Pinned Allenhead (DWP) : � <br /> 1 <br /> Remarks: <br /> Signature: - <br /> 1 <br />