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DOULOS <br /> PAGE 06 <br /> SAMPLING INFORMATION SHEET <br /> C,�ient: <br /> Sampling Date: f 1 7 <br /> sitF Project No, <br /> _ Well Designation:_ r �`L <br /> Is setup of t;rIffic control devices required? YES time: _ <br /> Is there stcirc :.nc water in well box? hours <br /> Is top of casirig C:ut level? O YES Above I'0C3 Below ToC <br /> Is well cap seil_ed and locked? �N,O, � If no, see remarks <br /> Height of .4(311 c:r �in riser YES if no, see remarks <br /> Well cover r�,�,(� ; 811 gUV (in inches) <br /> �1 12" � 12" (MCO 8'�rPK---�� <br /> e ra 1<'s " AWP 12 11 cNX 3 6" CNI Other G <br /> General conclir_..on Of w head assem Excellent oad ) Fair poor <br /> Purging Equ ._t:~ >r, —2" disposable bailer <br /> 2" PVC bailer Submersible pump <br /> Dedicated bailer <br /> —4" PVC bailer _Centrifugal pump <br /> Sampled w:.t - Disposal bailer: Teflon bailer: <br /> Well D .•,trNter: 2",V— 411 6" all <br /> Purge Vol . Multiplier: 0 . 16 0.65 1 . 47 2 , 61 gal/ft. <br /> Initial Measurement su e <br /> nt <br /> Time: Time: 3 <br /> Depth of we Calculated purge: <br /> P `� 6 Depth to water• Actual purge: S y� <br /> Depth to water: <br /> start <br /> purge Sampling time:__ p <br /> Time: tamp, E. C. pH Turbidity Volume <br /> x : 31 � `� 1 // 6) 7 / 7 --_ <br /> - , <br /> -/S ---� <br /> 06 <br /> Sample appearance: Lock: /V 0I' - <br /> .Equipment regia e6 : (Check all that apply) Note condition of replaced item <br /> 2" Locking C.�ip: __. Lock #3753 :________ 7/32 Allenhead: <br /> 4" Locking Cap, ---_ Lock-Dolphin: 9/16 Solt: <br /> 6" Locking cap: -_ Pinned Allenhead (1DWP) <br /> Remarks : <br /> Signature: <br />