Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEEN' <br /> Client: 6&1< Sampling Date: G1 �2 "` OD <br /> Site: Project No. ; <br /> 161Well Designation: �W r <br /> `i,i <br /> Is setup of traffic control devices required" YES time: hours <br /> Is there standing water in well box? Y TkS Above TOC Below TOC <br /> Is top of casing cut level? No If no, see remarks <br /> Is well cap sealed and lockedP NO ?ZEV If no, see remarks <br /> Height of well casing riser (in inches) ; <br /> Well cover type: 811 UV 1211 UV 1211 EMCO 811 BK <br /> 1211 BK 1211 DWP 1211 CNI— 3611 CNI Other f 'L 'TG <br /> General condition of wellhead assembly: ExcellentGoo Fair Poor <br /> Purging Equipment: 211 disposable bailer ^Submersible pump <br /> 211 PVC bailer Dedicated bailer <br /> 4f1 PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer Teflon bailer: <br /> 1 <br /> Well Diameter; 211 411 611 811 <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement RecharcLe Measurement <br /> 1 <br /> Time: Z �,-� Time : ( / Calcuulated purge : 6 ; <br /> Depth of well . � 1- S Depth to water. dual purge : 6 T <br /> Depth to water :2-7 69 <br /> Start purge : 00 Sampling time: o t" <br /> Time Temp. E. C. pH Turbidity Volume <br /> 1 oo 6 q- o1 L, go & 7S L <br /> 1 /0031 -70 - u- 3 Y9 S 2 <br /> (0 : 3 BS 2 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 611 Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks - <br /> Signature : <br />