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' SAMPLING INFORMATION SHEET <br /> Client Ramage Env Sampling Date ' <br /> Site Stockton Metro Airport Project No <br /> Stockton Well Designation <br /> 1 <br />' Is setup of traffic control devices requnred9 ' YES time hours <br /> Is there standing water in the well box? Above TOC Below TOC <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(in inches) <br /> Well cover type 8" or 12"W I "EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"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" P C bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 0 16 065 147 2 61 gallft <br /> Initial Measurement Recharge Measurement <br /> -'gime S Time Calculated purge <br /> Depth of well Depth to water Actual purge 8 <br /> Depth to water '- <br />' Start purge —*>` Sampling time <br /> Time Temperature E C pil Turbidity Volume <br /> . T r 91 <br /> I <br /> Sample appearance Lock /�/b <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 />