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` DOIILOB ENVIRONMENTAL COMPANY <br /> SAMPLING INFORMATION f <br /> Client. <br /> . ,, Sampling Date: 4_�-�� <br /> ��- <br /> Site: Project No. :3(4-5��_ <br /> Well Designation: <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? yEg Above TOC Below TOC <br /> Is top of casing cut level? NO E If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casincj riser (in inches) : <br /> JV12' EMCO 8" BK <br /> Well cover type: 8" W <br /> 12" BK _ 12" DWP _ 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent Fair PoorEmm <br /> Purging Equipment: 2" disposable bailer Yubmersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer _Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> _ <br /> Well Diameter: 2" 400 6" 8 n <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Calculated purge• k,S <br /> ,v Time: Time: 3 <br /> Depth of well: ii•o°1 Depth to water: Actual purge:_ <br /> Depth to water: 7C-$ <br /> Start purge: Sampling time: 33 <br /> Time Temp. E.C. pH Turbidity Volume <br /> Sample appearance: C Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> �..- <br /> Remarks: <br /> Signature: <br />