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DOULOS ENVIRONMENTAL COMPANY SAMt_1NG INFORMATION SHEET <br /> aClient: Ultramar Diamong ShamrockSampling Date: e — <br /> Site: <br /> Site: Beacon 1641 _ Project No. : 98-641-01 <br /> 1210 East Hammer Laic <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 If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV12" UV12" EMCO 8" BIC <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent <:2oo 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:2s.— Teflon bailer: <br /> Well Diameter: 211�_ 4" 6" 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> easu eme Recharge Meaguremen <br /> Time: Time; r Calculated purge: <br /> yV Depth to water: ,� Actual purge: <br /> Depth of well: 7 y <br /> Depth to water: <br /> Start purge: 3 L& Sampling time:— : e9I <br /> Time Temp. E. C. pH Turbidity Volume <br /> y <br /> = S2 67• � 13y ( 7 Cy <br /> Sample appearance: Lock: �L <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />