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MONITORING WELL SAMPLING INFORMATION SHEET E <br /> Client: a.L z Project No: 94-y-7. priz-7 1 <br /> She:24sw fWeII Designation: <br /> lf1- <br /> r G� <br /> Is setup of traffic control devices requrredl GO YES Setup do Takedown time: hours <br /> Is there standing wafer in well boa? cq�) YES (Above TOC Below TOC) <br /> Is Top of Casing cut level' NC, >_ (If NO please explain in remarks) <br /> Is well cap sesled and lacked? NO Y (If NO please explain in remarks) <br /> Nsight of Well Casing Riser(in inches) <br /> General condthon of Wellhead assembly Excellent Good Fair Poor (Expimn in remarks) <br /> Purging Equipment: 2" DTisposabl alter Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC baiier <br /> Sampled with: Disposal bailer: Teflon Bailer: <br /> Well Diameter. 2" 3" 4„ 601 gu <br /> Purge Vol. Multiplier. 0. w 0.367 0.653 1.47 2.61 gaUtL <br /> Time: ` 2; Time: Calculated purge: <br /> Depth of well: 1� Depth to water: Actual purge: <br /> Depth to water:-t4 <br /> Start purge: 16, a Sampling time: S' Sampling Date: <br /> Time Temp ( F) E.C. pH Turbidity O (ppm) Volume (Gal.) <br /> ( o os 5 , 6 a 3s' 3 <br /> 101 �3 os <br /> Sampie appearance:� - <br /> OC samples collected at this well:� � Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced Item. <br /> 2" Locking Cap: Lock #2357: Lock#0909: <br /> 3" Locking Cap: Lock #3753: Lock-Dolphin: <br /> f <br /> " Locking Cap: Chevron Lock: <br /> Remarks: <br /> Signature Review <br />