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SAMPLING INFORMATION SHEET <br /> Client Ramage Env Sampling Date <br /> Site Stockton Metro Airport _ Project No <br /> Stockton Well Designation �2_ _ <br />' Is setup of traffic control devices required? YES tune hours <br /> Is there standing water in the well box? 0 Y Above TQC Below TQC <br /> Is top of casing cut leve] NO If no, see remarks <br />' Is well cap sealed and locked? ry NO ES1 If no,see remarks <br /> Height of well casing riser(un inches) �^ <br /> Well cover type 8"or 12"UV 12" EMCO 8" or 12"BK 8" Christy <br /> 12" Christy8"M&D �e 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 mailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br />' Purge Vol Multipher 0 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time ;? '15— <br /> Time — Calculated purge <br /> Depth of well G— ' 26 Depth to water r--- Actual purge a <br /> Depth to water ; d <br /> Start purgeSampling time <br /> Time Tern erature EC pH Turbidity Volume <br /> � • - e / 9 _ <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 /> Remarks <br /> Signature <br />