Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Sampling Date: - 3 -M -0/ 1 <br /> Site: Project No. : <br /> Well Designation: <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? If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : --/D <br /> Well cover type: 8" W 12" W 12" EMCO 8" BK <br /> 12" BK 12" DWPl�CNI 36 , CNI Other <br /> General condition of wellhead assembly: Excellent G�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: Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial easu ant Recharg@ Measurement <br /> Time: Time h _ C`f Calculated purge: 7 <br /> Depth of well : S 6 Depth to water: 2 ' / 0 Actual purger <br /> Depth to water: qf 337 <br /> Start purge: 2-. Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> k= 3 1 9S-O 1 7 .30 <br /> 6 = S <br /> 61 - -2 8--:TG 19, tz 1 ----� <br /> lb- Y6 1 G �- • 3 1 E �>o _ 16 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753: 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks : <br /> Signature : <br />