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10/01/1998 15 33 9167829054 <br /> DOLiL05 PAGE 05 <br /> DOULOS ENVIROURSUTAL COMPANY <br /> SAMPLING INF'ORMATTON SHEET <br /> Client: A t - Sampling Date• " 3 <br /> Site: r ; 1[fy Project No. : <br /> U Well Designation: <br /> t G fan <br /> Is setup of traffic control devices required? ORO YES time: hours <br /> Is there standing water in well box? QD YE <br /> IS tQp of casing cut level? s Above TOC Below TOc <br /> Is wall Cap sealed and locked? NO If no, Bee remarks <br /> Height of well casing riser (in inches) : 16 E If no, gee remarks <br /> Well cover type: 8" UV 12" UV 12" EMCo g�+ BK <br /> 12" BK 1Z" DWP 12" CNI Err GNI ` <br /> on of wellhead assembly: Excellent anther `M+ <br /> General condition <br /> Fair Poor <br /> dmw�Purging Equipment: 2" disposable bailer <br /> — Submersible pump <br /> _2" PVC bailer Dedicated bailer <br /> 4"' PVC bailer __Centrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> ia <br /> Well Diameter: 2 N 4 I+ 611 801 <br /> L"arge Vol. Multiplier: 0. 16 0,65 1.47 2 . 61 gal/ft. <br /> su In ec-ar went <br /> R"Time' Time: Calculated purge: <br /> / . <br /> Depth of well: t Depth to water: P ge: <br /> Depth to water: 3 . ActuaX purge; i, <br /> Start purge: Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7.1, L <br /> ass 9 16 .L 740 2 <br /> 70. 518 71 3 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition <br /> Locking Cap:_ Lock #3753 ; of replaced item <br /> 4" Locking Cap:.-,-- ,,,�� Lock-Dolphin: ?/32 Allenhead: <br /> 611 Locking Cap: '--- 9/16 Bolt:, <br /> '�---- Pinned Allenhead (DWP) : <br /> Remarks; <br /> Signature: <br /> a t <br />