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DSAMPLING INFORMATION SHEET <br /> OULOS ENVIRONMENTAL COMPANY <br /> Sampling in Date• <br /> Client: Ultramar p g <br /> Site: Beacon #695 Project NO. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation: MW- <br /> Lodi CA <br /> Is setup of traffic control devicesrequired? YES timAboveTOC ow T. hours <br /> Is there standing water in well box,. NO �E <br /> is top of casing cut level? NO S If no, see remares <br /> 7 NO If no, see remarks <br /> Is well cap sealed and locked. <br /> Height of well casing riser (in inches) : 12" EMCO 8" BK <br /> Well cover type: 8" UV 12" W <br /> 12" BK 12" DWP A 12" CNI 36" CNI then <br /> General condition of wellhead assembly: Excellent Goo Fair Poor <br /> Purging Equipment: 21+ disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: --\-, Teflon bailer: <br /> " " 8+, <br /> Well Diameters 2" 46 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Ah Time: �- Time: 6 Calculated purge: <br /> Depth of well: 70 IQ Depth to water: Actual purge: » <br /> Depth to water: 6u7,�. <br /> �� Sampling time: 3 <br /> Start purge: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 317 fz Ltd 7510- <br /> 3� 1 <br /> 333 <br /> ff 70 1 74 <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 /> 4" Locking Cap: Lock-Dolphin:_ 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />