Laserfiche WebLink
y FY+ z 1 F r 1--w`^_ _"'_..,y.y»s l.....n♦F kt'yC r. ._u V ' <br /> DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client -A Sampling Date — 0 <br /> . Site AZA <2 . _. L4S� Project No <br /> _ _ nv�✓�bY, ____�_ Well Designation <br /> 1-4, C,A <br /> is getup of traffic control devices required YES time hours <br /> Is there standing water in the wetl boxy YES Above TOC Below TQC <br /> Is top of casing cut lever NO If no,see remarks <br /> 1s well cap seated and locked9 NO If no,see remarks <br /> Height of well casing riser(in inches) <br /> %�ell cover Type 8" or 12"UV 12"EMCOr 12" BK_ 8"Christy <br /> 12 Chrisry 8" M&D 12"M&D 12"DWP <br /> 12 ' C'N'1 36" CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Fair Poor <br /> Purging Equipment 2" disposable bailer K Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer P Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8)1 — <br /> Purge <br /> "Purge Vol Multiplier 016 065 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time 67 : 3 Time e0 Calculated purge �6^� <br /> Depth of well I & t 5 Depth to water S Actual purge 6 <br /> Depth to water '-t G 7,� <br /> Start purgeSampling time <br /> Time Tem erature E C pH Turbidity Volume <br /> � v � � 1 � • ``f2 2 <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2" Locking Cap Lock 7/32 Allenhead <br /> 4" Locking Cap Lock-Dolphin 9/16 Boit <br /> 6" Locking Cap Pinned Allenhead (DWP) <br /> �emarks <br /> Signature <br />