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08/16/2000 08 24 9167829054 DOULOS PAGE 05 <br /> DOQLOS ENVIRONMENTAL COKPANY S INFORMATION SHEET <br /> Client•A!fq- Sampling Daae: 19 eq <br /> -- <br /> Site : Arc- C, �DS6� _ Project No. • Arca{ DWO <br /> { r <br /> b _�-byts e well Designation. <br /> 5g �\A -02 LA. <br /> Is setup of trafF;c control devices required? YES time: hours <br /> Is there standinq water in well box? Above TOC Below TOC <br /> Is top of nasinq cut level? NO if no, see remarks <br /> Is well cap se s Led and locked? YES If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type , 8" UV 12+' VV 121, EMCO S�� SK � <br /> 12" BY 12 " CIWP 12" CNI__w____ 36" CNI_ Other Z <br /> General condi+ of wellhead assembly: Excellent Good Fair Poor <br /> Purging Equ1pr+F-- 21, disposable bailer Submersible pump <br /> 2" PVC bailerDedicated bailer <br /> 411 PVC bailer C Centrifugal pump <br /> Sampled w4th. Disposable bailer: Teflon bailer; <br /> Well D imeter: 2" 4'%2—( <br /> +`-}-( 6" $10 <br /> Purge Vol . Multiplier: 0. 16 06=55 1. 47 2 . 61 gal/ft. <br /> Initial MeeLsur��entRe ch rqe Measurenej]t <br /> Time: 13 I7_ Time: Calculated purge; YO. 1 . <br /> Depth of well _ � � Depth to water: Actual purge: j?e5.6n <br /> Depth to water <br /> Start purge: _ Sampling time: Al <br /> Tire "Temp. E. C. pH Turbidity Volume <br /> � 3 s 30 Ll 1 � 7 * <br /> - - -- o <br /> 114z�? o2-z. <br /> Sample appearance: Lock: <br /> Equipment replaces (Check all that apply) Note Condition of replaced item <br /> 2" Locking Car _ Lock , 3753: 7/32 Allenhead: <br /> 4" Locking Ca.� • _� F Lock-Dolphin:,�� 9/16 Bolt : <br /> 6" Locking Car, — Pinned Allenhead (DWP) • <br /> Remarks: , <br /> Signature: <br />