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SAMPLING INFORMATION SHEET <br /> Client Ramage Env Sampling Date '3 <br /> Site Stockton Metro Airport _ _ Project No <br /> Stockton Well Designation <br /> Is setup of traffic control devices requrred9 YES time hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked? 3 NO E71M If no,see remarks <br /> Height of well casrng riser(in inches) <br /> Well cover type 8"or 12"UV 12" EMCO 8"or 12"BK 8"Christy <br /> 12" Christy8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good 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__,>e— Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time Time lrn 'l S, Calculated purge <br /> Depth of well Depth to water ti Actual purge - <br /> Depth to water 41 7.J10 <br /> Start purge C Sampling time Z6 -Y '7 iD <br /> Time Temperature E C H _ Turbidity Volume <br /> Sample appearance Lock ' <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7/32 Allenhead <br /> 4" Locking Cap Lock-Dolphin 9/16 Bolt <br /> ' 6" Locking Cap Pinned Allenhead (DWP) <br /> 10 Remarks <br /> E <br /> Signature <br />