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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEB_ <br /> t, <br /> Client: Sampling Date: ' <br /> i <br /> Site: Project No. • 14761� <br /> elf yf ayyg _ Well Designation: <br /> J:r--Gt�' cell, <br /> Is setup of traffic control devices required? qO YES time: hours <br /> Is there standing water in well box? NO a Below TOC <br /> Is top of casing cut level? NO I 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" UV12" W 12" EMCO BR <br /> 12" BK 12" DWP 12" CNI 36" CNI Other /Z MiD <br /> General condition of wellhead assembly: Excellent Good ai Poor <br /> Purging Equipment: 3 2'�disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 2" 4" 61!Y,— 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2.61 gal/ft. <br /> 'AllikInitial Measurement Recharge- Measurement <br /> Time: Time: f8 Calculated purge <br /> Depth of well: 61. Depth to water: Actual purge: <br /> Depth to water: • 01 <br /> Start purge: GDS p Sampling time: �15 <br /> Time Temp. E.C. pH Turbidity Volume " <br /> 7.30 <br /> Sample appearance: Lock: 3,753 <br /> Equipment replaced: (Check all that apply) Note condition of -replaced item - <br /> 2" Locking Cap: Lock 13753: 7/32 Allenhead: <br /> 4+, Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />