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DOULOS ENVIRONMENTAL COMPANY SANNOW INFORMATION SHEET <br /> • Client: Sampling Date• &A <br /> Site . Project No. : <br /> Well Designation:-A <br /> GA <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? NO If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) <br /> Well cover type: 8" UV 12" W 12" EMCAher 8" BK <br /> 12 " BK 12" DWP 12" CNI 36" CNT <br /> m <br /> General condition of wellhead assebly: Excellent Fair Poor <br /> Purging Equipment: 2" disposable bailer -�J Submersible pump <br /> 2" PVC bailer i—Dedicated bailer <br /> 4" PVC bailer Centrifugal pump- <br /> Sampled with: Disposable bailer: Teflon bailer: `' ? <br /> v <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1 . 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time : / 4iZo Time: 1 Calculated purge . <br /> Depth of well : 5, h; Depth to water: O �} Actual purge : ,:�&J -- <br /> Depth to water: 161,62- <br /> Start <br /> q,6ZStart purge : 17E? Sampling time•L?_i / <br /> Time Temp. E. C. pH Turbidity Volume <br /> /?03 173, 1 �_ <br /> ht-� 3 C2 <br /> i 1 -2o ,3 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2 " Locking Cap : Lock #3753 : 7/32 Allenhead . <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt <br /> 5" Locking Cap- <br /> Pinned Allenhead (DWP) <br /> • Remarks . <br /> Signature - <br />