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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Sampling Date:-9- 7 <br /> • Site: Ace-a= 1 - Project No. : 9 - � _0 <br /> 13 5 0 Well Designation: <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? 49 YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? O gb If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 800 BK <br /> 12" BK 12" DWP 12" CNI 36" CNI her/ <br /> General condition of wellhead assembly: Excellentoo Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: .- Teflon bailer: <br /> Well Diameter: 2" 4"^ 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0.`65 1.47 2 . 61 gal/ft. <br /> .Initial _Measurement Recharge Measurement <br /> Time: 41147 Time: 6-L L4 ._ Calculated purge: <br /> Depth of well: 4d'= Depth to water: Actual purge: RS-" )z <br /> Depth to water: ? O,5: <br /> Start purge: 647 Sampling time:_ 6L��_ <br /> Time Temp. E.C. pH Turbidity Volume <br /> p `7b .i - <br /> r, 13 6ej 13 56 <br /> 6/ 7 ff /tea J 3 <br /> 6L� Ql?$ //3q 7GY3 <br /> Sample appearance: _ Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt:, <br /> 6" Locking Cap: Pinned Allenhead (DWP) :_i <br />• <br /> Remarks: <br /> Signature: /�1L1i <br />