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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: — 4 <br /> Site: Beacon#3641 Project No,: <br /> 1210 E.Hammer Lanel400 Well Designation, /I U-P — <br /> Stockton Ca. <br /> Is setup of traffic control devices required? ro YES time; hours <br /> Is there standing water in the well box? 100, <br /> YES Above TOC Below TOC <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap sealed and locked? - NO L If no, see remarks <br /> Height of well casing riser(in inches); <br /> Well cover type; 8"or 12"UV 12"EMCO 8"or 12"BK 8" Christy <br /> 12"Christy8"M&D 12"M&D 12"DWP <br /> 12"CNI_ 36" C I 12"Pomeco Other; <br /> General condition of wellhead assembly: Excellent 0001_7)�-- Fair - Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer DOdieated bailer <br /> 4"PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter: 2" ,x— 4" 67' 811 <br /> Purge Vol. Multiplier: 0,16 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: 7135 Time: = 2 Calculated purge: Q <br /> Depth of well: 7/, S'O <br /> Depth to water: Depth to water: 9 Z Actual purge: 10 <br /> _�6'. � <br /> Start purge: SampIing time: <br /> Time Tem erature E.C. pH Turbidi Volume <br /> $ - 12 70 - S 30 7 , <br /> ?© - 0 <br /> o , <br /> � • r 2S / ? -13 <br /> Sample appearance: Lock: <br /> Equipment replaced: (check all that apply) Note condition of repfac'ed item(s) <br /> 2"Locking Cap: Lock: 7/32 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin: 9116 Bolt: <br /> 6"Locking-Cap: Pinned AIlerlhead (DWP): <br /> Remarks: <br /> Signature: <br />