Laserfiche WebLink
DOULOS ENVIRONXENTAL COMPANY 2J@kVa1&& INFORMATION SHEET <br /> Client: Sampling Date: <br /> Site V'(.C? Project No. <br /> �So t .)0 Well Designation: w` <br /> AAo 6 k+O Q_ C P, <br /> Is setup of traffic control devices required? CUO YES time: hours <br /> is there standing water in well box? In YES Above TOC Below TOC <br /> is top of casing cut level? N If no, see remarks <br /> is well cap sealed and locked? NoIf no, see remarks <br /> Height of well easing riser (in inches) ': <br /> Well cover type: 8" W 12" UV12" EMCO 8" K <br /> 12" BK 12 " DWP 12" GNI 36" CNz ther " <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2 " disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:—k_ Teflon bailer: <br /> Well Diameter: 2" 41" 611 B" <br /> Purge Vol . Multiplier: 0 . 16 0 . 65 1 . 47 2 . 61 gal/ft . <br /> Initial Measurement Recharge Measurement <br /> Time: 161. 5 Time: Calculated purge: <br /> Depth of well : 1, 6.1 Depth to water: Actual purge: <br /> Depth to water., C. r <br /> r. <br /> Start purge: Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> /viz _11C <br /> �r <br /> �'q- �7.lvf 176q 7J <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: 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 />