Laserfiche WebLink
DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET _ <br /> Client ,4_; t-�e '?5�vUfr7 nyL4'e:4 t:�!=J Sampling Date <br /> Site• � � e vt Protect No <br /> • / C Well Designation LcJ <br /> Is setup of traffic control devices required9 NO YES targe hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut level? N YES If no, see remarks <br /> 1s well cap sealed and locked NO If no, see remarks <br /> Height of well casing riser(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 <br /> General conditon of wellhead assembly Excellent Goad 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 Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time // Time �' Calculated purge <br /> ! Depth of well Q Depth to water Actual purge <br /> Depth to water <br /> Start purge Q;D Sampling time <br /> Time Tem erature E C pH Turbidity Volume <br /> /o:o <br /> r <br /> Sample appearance _ Lock <br /> Equipment replaced (check al(hat apply) Note condition of replaced item(s) <br /> 2" Locking Cap Lock 7132 AlIenhead <br /> 4" Locking Cap Lock-Dolphin 9/16 Bolt <br /> 6" Locking Cap- Pinned Allenhead (DWP) <br /> Remarks <br /> Signature <br />