Laserfiche WebLink
DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET - - <br /> Client4l F. e UIQ r+vu _._ Sampling Date <br /> Site Project No <br /> C L ti/f'-e- Well Designation t''f_ 'k- � <br /> --- <br /> Is setup of traffic control devices required9 YES time hours <br /> Is there standing water in the well box9 � 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 nser(in inches) <br /> Well cover type 8"or 12"W 12"EMCO 8" or 12"BK 8"Chnsty <br /> 12"Chnsty 8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other bfg- <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__4_ Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 0 6 065 147 2 61 gal/ft <br /> initial Measurement Recharge Measurement <br /> Tune Time Calculated purge <br /> • Depth of wellDepth to water Actual purge <br /> Depth to water <br /> Start purge f j�'�� Sampling time ` 14 <br /> Time Temperature E C pH Turbidi Volume <br /> - <br /> Z <br /> p 2- <br /> Lit, -Z 6C <br /> Sample appearance Lock LLL111 <br /> Equipment replaced (cher all that apply) Note condition of replaced item(s) <br /> 2" Locking Cap Lock 7132 Allenhead <br /> 4" Locking Cap Lock-Dolphin 9/16 Bolt <br /> 6" Locking Cap Pinned Allenhead (DWP) <br /> emarks L 1 r n <br /> Signature <br />