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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION <br /> LL SHEET <br /> Client Ultramar Sampling Date 3 <br /> Site Beacon #3641 Protect No <br /> 1210 E Hammer Lane1400 Well Designation <br /> Stockton Ca <br /> Is setup of traffic control devices required YES tune 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? 1 A NO If no, see remarks <br /> Height of well casing user(nn inches) <br /> Well cover type 8"or 12"UV 12" EMCO 8" or 12" BK 8"Christy <br /> 12"Christy8"M&D_N__ 12"M&D 12"DWP <br /> 12"CNI 36" CMI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Qood Fau 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" 6" g" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time _7:10 Time 0 : Calculated purge <br /> Depth of well 77— 9<t,09 Depth to water Of• 70 Actual purge <br /> Depth to water <br /> Start purge 9 , 1/0 Sampling time <br /> Time Temperature E C H /w TurbidityVolume <br /> �: l • ot a 7 . l 3 <br /> = 5LI 3 0 ? • y a <br /> Sample appearance Lock. <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 9/16 Bolt <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks <br /> • <br /> Signature <br />