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DOULOS ENVIRONMENTAL COMPANY 490foliNG INFORMATION SHEET <br /> Client: L-C_i��_ sampling Date: 6, 2-1'011 <br /> site : lco _ -- Project No, <br /> m •1 Well Designation:_/L Ar . <br /> LLA_ <br /> Is setup of traffic control devices required? 0 YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NO KES) If no, see remarks <br /> Is well cap sealed and locked? NO YQ2Za If no, see remarks <br /> Height of well casing riser (in inches) : L1--- <br /> Well cover type: 8" W 12" W 1211 EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI therJ3 ''r"'hf� <br /> General condition of wellhead assembly: Excellent (G000 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" 4114 6" 8'i <br /> • Purge Vol . Multiplier: 0 . 16 0 . 65 1 . 47 2 . 61 gal/ft . <br /> Initial Measuremei2t Recharge Keasurement <br /> Time: Time; Calculated purge:df <br /> Depth of well : �. � Depth to water: Actual purge:_ <br /> Depth, to water: 2Kf-3 <br /> Start purge: Sampling time: „_ <br /> Time Temp. E. C. pH Turbidity Volume <br /> L24,3 u 7 U- <br /> f a 7 <br /> 41 7 o 7 7J <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock , 3753 : 7/32 Allenhead: <br /> 41' Locking Cap: Lock-Dolphin; 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> • Remarks: <br /> Signature: <br />