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DOUL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> � s1 <br /> Client: Ultramar Sampling Date: <br /> 0 Site: Beacon_ #695 _ Project No. : 94-695-017 <br /> 900 S. Cherokee Lane Well Designation: MW- / <br /> Lodi, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? O (:!ED� If no, see remarks <br /> Is well cap sealed and locked? NO <M If no, see remarks <br /> Height of well casing riser (in inches) : _ 9 <br /> Well cover type: 8" UV 12" UV 12" EMCO 8'0 BK <br /> 12" BK 12" DWP 12" CNI < 36" CNI er <br /> General condition of wellhead assembly: ExcellentGoo Fair Poor <br /> �.. <br /> Purging Equipment: c�2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 211 X 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Kime: )y 11) __ Time: 2 . -5 Calculated purge:_, . 6 <br /> epth of well: 7 3 Depth to water: 7 �� Actual purge: <br /> Depth to water.. <br /> Start purge: / 5 Sampling time: O _ <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7y Sal 7•� i <br /> 1 '-59 713 7 51 <br /> �2 .01 -79>__6 7 1 7 <br /> 05 9 -" 76 3-5 1 • l1 q <br /> Sample appearance: Lock: C� ,,�r✓1 <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 414 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6t1 Locking Cap: Pinned Allenhead (DWP) : <br /> 0 Remarks: <br /> Signature: <br />