Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Sampling Date: Cl <br /> Site; Project No. : <br /> lrr�-ti mt 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? To a If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : 3 <br /> Well cover type : 8" UV12" W 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other 1 2 1= _ <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: 2"_>L 4" 6" 8" <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial <br /> Recharge Measurement <br /> Time: O Time: a�_ © Calculated purge . <br /> Depth of well : s- Depth to water: �'�a Actual purge . <br /> Depth to water: <br /> Start purge : `s Sampling time: - 0 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3 67- 3 � l � 7 - d <br /> o �- <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 Boit: <br /> 6" Locking Cap: Pinned Allenhead (DWP) :_ <br /> Remarks: <br /> Signature: <br />