Laserfiche WebLink
DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: )--3 "77 <br /> iSite: Beacon #695 _. Pro]ect No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation: MW-30 <br /> Lodi, CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing out 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) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI X 36" CNI Other <br /> General condition of wellhead assembly: Excellent CL-01 Fair Poor <br /> .!®IIIIIIIAS I ISI■ I -- X11.111® <br /> Purging Equipment: k 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: I �_LfI Time: Calculated purge: <br /> Depth of well: Depth to water: Actual purge: <br /> Depth to water: F N,Z { <br /> Start purge: 313 Sampling time: 40/ <br /> Time Temp, E.C. pH Turbidity Volume <br /> /C 70, 1 3 _ Ll <br /> 3 .1-Z u IZe772 � -21 <br /> 3i9 � 7z /Oil <br /> Sample appearance: LZ4.1144 Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Panned Allenhead (DWP) : <br /> Remarks: <br /> Signature: 11�Q <br />