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DOUL08 ENVIRONMENTAI, COMPANY , S INFORMATION SHEET <br /> • Client: � �a Sampling Date: =00 <br /> Site• 6 Project No. : <br /> Well Designation: W //3 <br /> Is setup of traffic control devices required? YES time : hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? N If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : 3 <br /> Well cover type: 8" UV 1.2" UV 12" EMCO 8" B <br /> 12" BK 12" DWP 12" CNI 36" CNI 600t <br /> her/)- '41General condition of wellhead assembly: Excellent 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: Teflon bailer: <br /> Well Diameter: 211 4" 6" 8" <br /> Purge Vol . Multiplier: 0 . 16 0 . 65 1. 47 2 . 61 gal/ft <br /> � In;tial Measurement Recharge Measurement <br /> Time :_ / L� 3I_ Time:--L601 _ Calculated purge . z <br /> Depth of well :_, e q C� Depth to water: L_ �,3 ly Actual purge : 91s <br /> Depth to water: <br /> Start purge : /S �j s Sampling time:_J� d 2__ <br /> Time Temp, E. C. pH Turbidity Volume <br /> 1 Z 2.1-7 <br /> ISEJ 9/0 L4 D <br /> �S o g 2 �sa <br /> 73 <br /> Sample appearance: f Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 113753 : 7/32 Allenhead: <br /> 4 " Locking Cap: Lock-Dolphin: 9/16 Bolt , <br /> 6" Locking Cap. Pinned Allenhead (DWP) . <br /> . Remarks <br /> Signature <br />