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------------------------ <br /> VOULOO MVIROJDUWJLL COXpANY sAMPLING INFORMATION SHEET <br /> Client: U t Sampling Date: <br /> Site: BeaconProject No. : 94 -01 <br /> 1 _ <br /> 401 W. K, pttan well Designation:_ MW- 1 <br /> Lodi, ch <br /> Is setup of traffic Control devices required? Q YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NO VM If no, see remarks <br /> Is well cap sealed and locked? o If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" W 12" EMCQ 8" BK <br /> 12" BK 12" DWP 1211 CNI 36" CNI ther <br /> General condition of wellhead assembly: Excellent vo Fair Poor <br /> Purging Equipment: 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" 411 611 8" <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2.61 gal/ft. <br /> Initial M9asurementRec r t <br /> Time: 166 Time: 0 Calculated purge: 1 <br /> Depth of well: 74 .2.5 Depth to water:I-LActual purge- r._ <br /> Depth to water:meq _ <br /> Start purge: /030 _ Sampling time.- <br /> Time <br /> ime:Time Temp. E.C. pH Turbidity Volume <br /> 16J4 70. 61 1 <br /> qJ- ,3 2 <br /> R IL, 7S 0 r <br /> 3 <br /> /1026 6(-. 6 <br /> Sample appearance: _� � Lock: <br /> Equipment replaced; (Check all that apply) Note condition or replaced item <br /> 2 Locking Cap:� Lock #3753: 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Dolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> � Signature: <br /> / Ii/L <br />