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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 45 -2- ?-OS <br /> Site: Beacon#3641 Project No.: <br /> "- 1210 E.Hammer Lane 1400 Well Designation: <br /> Stockton Ca. <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked? NO If no,see remarks <br /> Height of well casing riser(in inches): S <br /> Well cover type: 8"or 12"W I2"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other: <br /> General condition of wellhead assembly: Excellent Good__>!S,- 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: Disposable bailer Teflon bailer Disposable Tubing_ <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: 2 '- 2 8 Time: Q <br /> _1_- � Calculated purge: q - <br /> Depth of well: 13 Y Depth to water: 70 , 3 Actual purge: o <br /> Depth to water: 5 q- <br /> Start purge: =OO Sampling time: 1 ' 3 3 <br /> Time I Tenn erature E.C. H Turbidity Volume <br /> l� o 70 2 D 7 -g <br /> ? Q <br /> 2- <br /> 7 7 • l y� 7r S ' <br /> 3 <br /> Sample appearance: ���-- Lock: <br /> i <br /> Equipment replaced: (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap: Lock: 7132 Allenhead: ` <br /> 4"Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6"Locking Cap: Pinned Allenhead (DWP): <br /> Remarks: <br /> t <br /> Signature: <br /> 4 <br />