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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: `q 7 <br />• Site: Beacon #695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation: MW- JJ <br /> Lodi CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? 4Above TOC Below TOC <br /> Is top of casing cut level? No If no, see remarks <br /> Is well cap sealed and locked? NO E If no, see remarks <br /> Height of well casing riser (in inches) : 3 <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 1.2" DWP K 12" CNI 36" CNI her <br /> General condition of wellhead assembly: Excellent Go 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: Disposal bailer: Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61. gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: 11401 Time: SaZ Calculated purge: <br /> Depth of well: -74. Depth to water: Actual purge: <br /> Depth to water: 6 to 2-7 <br /> Start purge: Sampling time: S1 3 <br /> Time Temp. E.C. pH Turbidity Volume <br /> tit W5 ICE5i <br /> 19023 <br /> L453 46:6 � 3 <br /> Sample appearance: Lock: 4 <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 />