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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 9-2 <br /> p <br /> Site: Beacon#3641 Project No.: <br /> r 1210 E.Harnmer Lane 1400 Well Designation: Al w <br /> Stockton Ca. <br /> Is setup of traffic control devices required? � YES time: hours <br /> Is there standing water in the well box? �1Qa� YES Above TOC Below TOC <br /> Is top of casing cot level? O 61M> <br /> If no,see remarks <br /> Is well cap sealed and locked? NO If no,see remarks <br /> Height of well casing riser(in inches): / 0 <br /> Well cover type: 8"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy8"M&D__Z,_ 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other: <br /> General condition of wellhead assembly: Excellent Good Fair Poor <br /> Purging Equipment: 2"disposable bailer X Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4"PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer Teflon bailer Disposable Tubing_ <br /> Well Diameter: 2" 4" X_ 6" g)° <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 gal/t. <br /> Initial Measurement Recharge Measurement <br /> Time: 9 . 3.2- Time: 19- : Calculated purge: V6 -3 <br /> Depth of well: 72- -!0 Depth to water:_ 5 7- 3 Actual purge: <br /> .: Depth to water: -7 <br /> Start purge: /2 =l4 Sampling time: <br /> Time Temperature E.C. pH I Turbidi Volume <br /> 1 7-/ 2 <br /> /2 .20 0 % 2 262 7-/ 3 <br /> JZ- Z4 70 - 3 2- 5;a -7 . 05? 3 <br /> 0 70 - ? 2 0 7- 0y y <br /> Sample appearance: _ [�C�c�es� Lock: <br /> - <br /> Equipment replaced: (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap: Lock: 7/32 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin: 9116 Bolt: <br /> 6"Locking Cap: Pinned Allenhead(DWP): <br /> Remarks: <br /> Signature: <br /> 'E <br /> E <br />