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DOULos ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> now <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon #695 Project No. : 94- 695--01 <br /> 900 S. Cherokee Lane Well Designation: M�- ANA/-L <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 ID If no, see remarks <br /> Is well cap sealed and locked? NO 2 If no, see remarks <br /> Height of well casing riser (in inches) : _ -6 <br /> Well cover type: 8" UV 12'1 UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI )(-' Other <br /> General condition of wellhead assembly: Excellent Co-60 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" 611 _ 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement R_echarae Measurement <br />. <br /> Time: /)-uV Time: /59 Calculated purge: /OFr <br /> Depth of well: '330 Depth to water: 65 13 Actual purge: 10,r- <br /> Depth <br /> p,Depth to water: 69 i / <br /> Start purge: IIS Sampling time: ZOO <br /> Time Temp. E.C. pH Turbidity Volume <br /> 193 <br /> 70 , <br /> 4 .L 133 SLS2 <br /> )45 6 7 �' l�'�z 740 L P <br /> Sample appearance: Lock: 1<. <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> . Remarks: <br /> Signature: <br />