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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> CLent Ultramar Sampling Date q -1S <br /> Site Beacm#695 Project No 94-695-01 <br /> Well Designation MW- �q <br /> Lodi.CA .. _ <br /> Is setup of traffic control&mcxs rNuuvd? YES tune hours <br /> Is there standing water in well bort? YES Above TOC Below TOC <br /> Is top of casing cut level? NO 1f no,neo remarks <br /> Is well cap sealed and locked? NO If no,coo remarks <br /> Height of well casing user(m inches) <br /> Well cover type 8"UV 12"UV I2"EMCO 8"BIC <br /> 12"BK 12"DPW 12"CNl ,3d'CNI__ Outer <br /> General condition of wellhead assembly Excellent 3b Fav Poor <br /> Purging Equipment: 2"disposable baler Submersible pump <br /> 3"PVC bailer Dedicated bailer <br /> 4" PVC batter __�/_ _Centrifugal pump <br /> Sampled with. Disposable bailer Teflon bailer <br /> Well dsametw 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 063 147 2.61 gam <br /> Initial Measurement RoohnM MeasmEmml <br />. Tune P-4 Tun® _ 6141_ Calculated purge L_0 <br /> Depth of well ..2L 6_�t_ Depth to water Actuol purge <br /> Depth to water 6 t, 7 9 <br /> Start purge Sampling tutu <br /> Tune Temp"Um E. C pH Turbidity Volume <br /> !113 Zdf <br /> 71,E <br /> 3 <br /> _f4 0--f_2Y 0 <br /> Sample appearance g Lock <br /> Equipment replaced (Chad all that apply) Note coadtttau of replaced items <br /> 2" locking cap Lath 03753 7/32 Allenlaa& <br /> 4" locking cap Lock-Dolphin 9116 bob <br /> 6" locking asp Punned AllenhoW(DPW) <br /> Remaft <br /> Signature ,A <br /> F <br />