Laserfiche WebLink
DODLOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Sampling Date: <br />. Site: 6 41/ Project No. : <br /> d E I7Gl/ zrrA-y c�e<mC Well Designation* /� w <br /> G <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" UV 12" EMCO 8" BK__� <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent � 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 . <br /> Well Diameter: 211 41' 6" 8" <br /> Purge Vol . Multiplier: 0 . 16 0 . 65 1 . 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement � C <br /> Time . Time: -7 S O Calculated purge : <br /> Depth of well : -7t/ V3 Depth to water: So / Actual purge <br /> Depth to water, =15 ___ <br /> Start purge : -7 Y 0 Sampling time:- -7 S <br /> Time Temp. E.C. pH Turbidity Volume <br /> Lit 6 8 s ! 3 0 7 <br /> 7 �� 6� •� 13y Z 2 --� � <br /> 70 7 / 7 3 <br /> 7 ' 3 69 <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 /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks : <br /> Signature : <br />