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DOOL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: � �r.d�. Sampling Date: <br /> Site . _ L,e4il Project No. : <br /> �� d 17ct/1n�t-r�p� C Well Designation: <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's NO eJM If no, see remarks <br /> Is well cap sealed and locked9 N0 if no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type : 8'" W 1.2" W 12" EMCO 8" SK <br /> 1211 BK 1211 DWP �7 CNI�_ 3611 CNI Other <br /> General condition of wellhead assembly: Excellent giE2 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: 2" 4 O 6" 8" <br /> Purge Vol . Multiplier: 0 . 16 0 . 65 1 . 47 2 61 gal/ ft <br /> InItIal Measureme t Recharge easurement �, 7 <br /> Time : 7 Time: � / Calculated purge <br /> Depth of well : 73' 0 7 Depth to water: � � Actual purge .�� <br /> Depth to water: <br /> Start purge: Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> �l G bl cl- ,/ v 7 -S I <br /> - ; <br /> 6,7 S 1 f 6 7 - Y6 2 <br /> 2 ' S21 70 0 I r 11 7 9` 1 3 <br /> 10;0� 70 , y $0 7- e10 <br /> Sample appearance: LeP 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 />