Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: <br /> Sampling Date: - 7 <br /> Site: <br /> Project No. : y- 14 <br /> Well Designation: <br /> Is setup of traffic control devices required? � YES time.TOC Below TOC <br /> hours <br /> Is there standing water in well box. No If no, see remarks <br /> Is top of casing cut level? NO YE If no, see remarks <br /> Is well cap sealed and locked.' <br /> Height of well casing riser (in inches) : <br /> 12" EMCO➢L 8" BIC <br /> Well cover type: 8" W 12n WOther <br /> 12" . BK 12" DWP 12" CNI 36" CNI <br /> General condition of wellhead assembly: Excellent o Fair Poor <br /> 2" disposable bailer -k—Submersible pump <br /> Purging Equipment: <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:_ Teflon bailer: <br /> Well Diameter: 2" <br /> 4 6„ all <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2. 61 gal/ft. <br /> tial Measurement Rechar a Measurement ppc� <br /> � Calculated purge: <br /> Time: <br /> S 10 Depth to water: A Actual purge: <br /> Depth of well: �1 <br /> Depth to water: <br /> Start purge: 0 Sampling time:_ 1 . <br /> Time Temp. E.C. pH Turbidity Volume <br /> 10 93 <br /> (2: 73 , S r2Gd -7,q 0 3 <br /> Sample appearance: 1/Z/ Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item - <br /> 2" Locking Cap <br /> 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 />