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10/01/1998 15 33 9167829054 <br /> " DOL1LD5 PAGE U4 <br /> DOULO$ ENVIRONMENTAL COMpANY r <br /> SAMPLING INFQP14ATION SHEET <br /> Tient: A 1 "t <br /> sampling Date- <br /> Site: PIre Fcoa ;llty Project No. : <br /> 4.1 Well Designation: <br /> LAIs Setup of traffic control devices required? YES time: <br /> ' Is there standing water in well box? hours <br /> Is top of casing cut level? YES Above TQC Below TOC <br /> Is well Cap sealed and locked? If no, see remarks <br /> Height of well casing riser (in inches) : If no, see remarks <br /> 1 <br /> Well Cover type-. 8" UV 12" TN 12" EMCO 8" BK_ <br /> " BK 12 11 UWP 1.2 01 CNT <br /> General condition of wellhead assembly: Excellent GoodherFair oor ' <br /> ' Purging Equipment: 2" disposable bailer Submersible <br /> 2" PVC bailer pump <br /> Dedicated bailer <br /> -4" PVC bailer ' centritugal pump <br /> Sampled with: Disposable bailer:-V- Teflon bailer: <br /> Well Diameter: 2" f 4" 6" __ 811 <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 gal/ft. <br /> meAffinitial. Measurementc ar a Measurement <br /> iMe! Time: Calculatedur e. <br /> Depth of well: 70 73 Depth to water: -76 <br /> Depth to water• 6 � �� Actual purge: ' <br /> ,�� <br /> purge: • i <br /> Start 3 <br /> ! Sampling time: D Ig <br /> Time Temp. E.C. pH Turbidity Volume <br /> 163 3 3 ! 01 <br /> loll , 1 30-J_ 755 .� <br /> sa <br /> mple appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition oi° <br /> 2 Looking Cap: replaced item 03753: <br /> 4" Locking Cap:� Lock-Dol hin: x/32 Allenhead� <br /> G" Locking Cap: P 9/16 Bolt: <br /> MMMM� Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />