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SAMPLING INFORMATION SHEET <br /> Client Ramage Env Sampling Date <br /> owl Site Stockton Metro Airport Project No <br /> Stockton Well Designation M t" <br /> Is setup of traffic control devices recluued9 YES tune hours <br /> K <br /> Is there standing water in the well boxy OYEFi Above TOC Below TOC e <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO If no,see remarks <br /> Height of well casing riser(m inches) <br /> -W-ell cover type 8"or l2"UV 12"EMCO V or 12"BK V Christy <br /> 12"Chnsty8"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__�<' Teflon bailer Disposable Tubing <br /> Well Diameter 2" �Z--^ 4" 6" 8" <br /> Purge Vol Multiplier 0 16 065 147 2 61 gaUft <br /> Initial Measurement Rechar e Measurement <br /> Time Time �.�: Calculated purge r <br /> Depth of well Depth to water L 510 Actual purge <br /> Depth to water V223 <br /> Start purge Z5 _* ;? Sampling time <br /> Time Temperature E C PH Turbidity Volume <br /> Ileti <br /> t <br /> Sample appearance � f�t�, � ;� Lock .� L <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 /> Remarks <br /> Signature <br />