Laserfiche WebLink
r� <br /> 1 DOULOS ENVIRONMENTAL, INC SAMPLING INFORMATION SHEET <br /> Client Sampling Date <br /> i Site <br /> Project No <br /> Well Designation W <br /> li <br /> Is serup of traffic control devices required 0 YES time hours <br /> f' is then standing water in the well box9 YES Above TOC Below TOC <br /> is top of casing cut leve � <br /> 6TM If no,see remarks <br /> Is \�ell cap sealed and locked9 NO If no, see remarks <br /> Height of well casing riser (in inches) <br /> 'tib ell cover type 8" or 12" UY 12" EMCO 8" r 12" BK_� 8" Christy- <br /> 12 <br /> hristyi2 Christy 8"M&D 12" M&D 2"DWP <br /> 12 ' CNi 36" CNI 12"Pomaco 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 Centnfugal pump <br /> Sampled with Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" g" <br /> Purge Vol Multiplier 0 16 065 1 47 2 61 gal/ft <br /> i initial Measurement Recharge Measurement f <br /> Time 10 : O 6' Time 11 ' S Q Calculated purge ! <br /> Depth of well I D ct - 1 Depth to water 4 I 0 Actual purge <br /> Depth to water g �� <br /> Start purge 3,3- Sampling time ` S <br /> Time Tem erature E C PH Turbidity Volume <br /> -7 -7 <br /> �5 933 <br /> D 6� Cf J 33 - � 3 <br /> Sample appearance Lock Y <br /> Eguipme,rit replaced- (chcck all that apply) Noie conaition of replaced item(s) - <br /> 2" Locking Cap Lock 7/32 Allenhead <br /> 4" Locking Cap Lock-Dolphin 9/16 Bolt <br /> 6" Locking Cap Pinned Allerihead (DWP) <br /> Remarks <br /> Signature <br />