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,94/03/1998 09:44 9167829PF4 DOUL❑S PAGE 02 <br /> DOULOS 8NVI80N1t3NTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Llhte Sampling Date: <br /> site:_ (� 446 S ,,w Project No. : <br /> CA- '15-L()3 Well Designation: <br /> Is setup of traffic control devices required? NO YES time: hours <br /> Is there standing water in well box? NO YES Above TOC Below TOC <br /> Is top of casing cut level? AIA NO YES If no, see remarks <br /> Is well cap sealed and locked? NO YES It no, see remarks <br /> Height of well casing riser (in inches) : <br /> well cover type: 8" W 12" UV 1211 EMCO 8" BK_ <br /> 12" BR 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent Good Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump 'l <br /> Sampled with: Disposable bailer: Teflon bailer: •�ca�Hwy. <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2. 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: 7S4 Time: Calculated purge: SO <br /> Depth of Well: */50 Depth to water:�,gActual purge: Svc <br /> Depth to water: <br /> Start purge: 6116 Sampling time: 9 2 O <br /> Time Temp. E.C. pH Turbidity Volume <br /> a 603 /�.2.X64, <br /> 8.37 6 a, 1- /1 7 T O <br /> y40 s I r5o 7- 31r <br /> Fr i S�. I v o l 7. 57 --- <br /> 906 S 17 7a x•36 r <br /> Sa4fe ap"i$nce: `�3 3 Lock: A/ <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Capp, Lock 13753: 7/32 Allenhead: <br /> 4" Locking Capi Lock-Dolphin: 9/16 Holt: <br /> 6* Locking Cap: _ .......__ .._ Pinned Allenhead (DWP) : <br /> Remarks: iru� 4A4� �L_dtw - e� Q <br /> I <br /> _ 1 <br /> Signature: <br /> 1 <br />