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DOULOS MMIRONNENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: <br /> t r Sampling Date: <br /> Site: Reag2n #695Pro]ect No. : 94-695-01 <br /> 900 S. Cherokee &Ane Well Designation:^ KWn_0 <br /> LqSji, CA <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 15M If no, see remarks <br /> Is well cap sealed, and locked? NO jW If no, see remarks <br /> Height of well casing riser (in inches) : 3 <br /> Well cover type: 80 UV 120 W 12" ZKC0 8 p1 BE <br /> 1219 BK 12" DWP 1294 CNI 360 CNI� then <br /> General condition of wellhead assembly: Excellent o Fair Poor <br /> Purging Equipment: );:� 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 400 PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 200 440 640 800 <br /> Purge Vol. Multiplier: 0. 16 0.65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: `7n9 Time: 364 Calculated purge:-/ <br /> Depth of well: 6 Derth to water: 7 4F4 Actual purge:- •may <br /> Depth to water: 197. 3 <br /> Start tLpurge: ZQf4 Sampling time: 36 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3 46 6 q 1_ 81- <br /> ,3 1 <br /> 1-3l 692 <br /> 3.1-3 7J 61l_T <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 201 Locking Cap: Lock #3753: 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 611 Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: ��—�' <br />