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. DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon #695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation: MW-ol%7 <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? NO IM) If no, see remarks <br /> Is well cap sealed and locked? NO YIf no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" W 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI�_ 36" CNI --Other <br /> General condition of wellhead assembly: Excellent t000Fair Poor <br /> Purging Equipment: -x 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 /> iInitial Measurement Recharge Measurement <br /> Time: /�2-3r Time: f/dCalculated purge: <br /> Depth of well: 15.11- Depth to water: Actual purge: <br /> Depth to water: 6,6 /6 <br /> Start purge: Mo Sampling time: ?' 17 - <br /> Time <br /> 17 - <br /> Time Temp. E.C. pH Turbidity Volume <br /> 74}3 q 9 7 <br /> ------ <br /> #0 <br /> 7 a I eL � ` <br /> Sample appearance: rte_, Lock: •Y� <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: _ J�-�1 ^-dam• <br />