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_ ' "'�� Uo•r�� yzbr824654 DOULOS <br /> PAGE 64 <br /> 1AXPLING INFORMATION SHEET <br /> Client -�� <br /> Sampling Date: 1 7- <br /> Site:_ �7Q <br /> s" Sp <br /> ; ... Project No. : <br /> well Designation: p✓IfA <br /> Is setup of traffic control devices required? t , <br /> rs there standing water in weld, box? YE <br /> Is top of casing cut ? hours <br /> IS well ca s g level. NO Ve TO 8elaw TOC <br /> p haled and looked? NO If no, see remarks <br /> Height of wel ! _acing riser NO If no, see remarks <br /> Well cover- type : 8 i W (In inches) ; Y <br /> 12" BK12 " DWP 12 rr 1211 EMCO 8 rr B <br /> General condition — CNI� K- <br /> °t We�.�.head assembly;CNI 36a Other <br /> E Other <br /> OMMFair Poor <br /> Purging Equip,,,,-,,t: —w..-21' disposable bailer <br /> 1 2" PVC bailer -,y_Submersible pump <br /> _411 PVC bailerDedicated bailer <br /> --�Centrifugal pump <br /> Sampled with: Disposal bailer: <br /> Teflon bailer:�� <br /> Well Diameter: Zrr� Orr <br /> 6 rr_ got <br /> Purge Vol . Multiplier: 0. 16 <br /> in-it ' 1 Measurement 0. 65 1. 47 2 . 61 <br /> ec a ure nt gal/ft. <br /> Time: 7= Time: <br /> Depth of well : 1 . 2. Q Depth to water: p, Calculated purge: <br /> Depth to water: 2 1 Actual purge: <br /> Start purge:_Jc-"U Sampling time: U <br /> Time Temp, E.C. PH 'turbidity Volume <br /> /0' 7 D 7-33 -�. <br /> 7 , 3 2 <br /> 49 <br /> Sample appearance: � wLr /e <br /> Lock: <br /> Equipment replaced : (Check all that apply) <br /> 2" Locking Cap:___ Note condition of replaced item <br /> 4" Locking cap.,__ Lock : 7/32 Allenhead• <br /> 611 Locking Cap: Lock-Dolphin: ' <br /> � --- <br /> Pinned Allenhead�(DWP) : <br /> Remarks: <br /> Signature: <br />