Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Sampling Date: <br /> Site : SG}/ Project No. : <br /> Ce&�� d l7�t�nir �yvrtiC Well Designation: w <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" UV12" W 12" EMCO 8" BK <br /> 1211 BK 121" DWP 12" CNI 3611 CNI Other Nl U <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 /> 4" PVC bailer Centrifugal pump <br /> Sampled with : Disposable bailer:—LtTeflon bailer: <br /> Well Diameter: 2" 4"_X- 6" 8" <br /> Purge Vol . Multiplier: 0 . 16 0 . 65 1. 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement_ 3 3 <br /> Time - 6 . <br /> Time: ' - 3 ^ Calculated purge: <br /> Depth of well . 7 �3 Depth to water: 50, / Actual purge <br /> Depth to water: S <br /> Start purge: 9 ' 0 ZSampling time: j <br /> Time Temp. E. C. pH Turbidity Volume <br /> 08 67. 8 1 � `I `to r <br /> X 62 9 ZC) .2 <br /> r `7 �� � � �' 7 - 30 -3 <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 />