Laserfiche WebLink
1 <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Sampling Date:--,f <br /> i <br /> Site: Project No. : <br /> l6/ Well Designation:_P/"l Lv - h <br /> LA i <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? � YE Above TOC Below TOC <br /> Is top of casing cut level? NO ES 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'" UV 12" W 12" EMCO 8" BK_� <br /> 1211 BK 121" DWP 1211 CNI 3611 CNI Other <br /> General condition of wellhead assembly: Excellent Good Fair <br /> Purging Equipment: 2" disposable bailer . Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: f Teflon bailer: <br /> Well Diameter: 2'"YL7 4" 611 811 <br /> s Purge Vol . Multiplier- 0 . 16 0 . 65 1. 47 2 . 61 gal/ft. <br />`s Initial Measurement Recharge Measurement <br /> Time: Time : CJ Calculated purge: � y <br /> Depth of well : S 7- 6S Depth to water: Actual purge <br /> Depth to water,. <br /> Start purge : Sampling time:td3 1 <br /> Time Temp. E. C. pH Turbidity Volume <br /> Sample appearance: Lock: / 7 /Z <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 />