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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site; Beacon #3641 Project No.: <br /> 1210 E.Hammer Lanel400 Well Designation: /I W <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? 0> If no,see remarks <br /> Is well cap sealed and locked? NO If no,see remarks <br /> Height of well casing riser(in inches): 7 <br /> Well cover type: 8"or 12"LTV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"M&D 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 - 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" 831 <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: g Time: y.' 30 _ Calculated purge: 97- 1 <br /> Depth of well: 117 - 95 Depth to water: _ 7 0 -3/ Actual purge: 7 . <br /> Depth to water: • / �; ='{ <br /> Startur e: = <br /> p g � � 7 Sampling time: 32— <br /> Time <br /> 2—Time Temperature E.C. pH Turbidi Volume <br /> YY / 3 -7 0 F z 9fy <br /> 0 7/ . 4 <br /> Sample appearance: Lock. <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: 9116 Bolt: <br /> 6"Locking Cap: Pinned Allenhead (DW): <br /> Remarks: LPA w 2 EC 2� <br /> Signature: <br />