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DOVLOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: <br /> Site: Beacon .J641 Project No. : 98-641-01 <br /> 1210 East_Hammer Lane Well Designation: *0" Ll� <br /> Stockton CA <br /> Is setup of traffic control devices required' � YES time: hours <br /> Is there standing water in 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 -99 If no, see remarks <br /> Height of well casing riser (in inches) : rl <br /> ff <br /> Well cover type: 8" UV 12" UV 12" EMC4 S" BK <br /> 12" BK 12" DWP " j'CNIX_ 36" CNI Other <br /> General condition of wellhead assembly: Excellent o 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:-4—< Teflon bailer: <br /> Well Diameter: 211_�L 4" 6" 8" <br /> Oplurge Vol.. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial--MgAsurement Rech&rae Measurement <br /> Time:, Time: Calculated purge: y <br /> Depth of well: 7`7 71 Depth to water: ' Actual purge <br /> Depth to water: `! 2 1 !J <br /> Start purge: 5 5"16 Sampling time: 6 � � <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3 //y6 7 2 / I <br /> IV 109q 7 3 <br /> 6-a3 G7 q6 7--.-.I J <br /> /y ` <br /> Sample appearance: 6-0211' Z Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Siqnature: <br />