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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: <br /> Site: Beacon #641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: <br /> Stockton C <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? 1P If no, see remarks <br /> Is well cap sealed and locked? N6 If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV12" UV 12" EMCO B" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other / 2 <br /> General condition of wellhead assembly: Excellent 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:-3-P- Teflon bailer: <br /> Well Diameter: 2" 4" X 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> initialMeagggement Recharge Measurement 7 r,� 2 <br /> Time: O <br /> r Time: S,�1 - 2. - Calculated purge: 4 <br /> Depth ofwell: 2 ' 3 Depth to water: y Actual purge:-I 1R 2 <br /> Depth to water: <br /> Start purge: 3 r Sampling time: '-�_ <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3Y l9 / � 1� S -7 •Yo <br /> lq, 3q -2o- y 6f/6? 7 - 3 3 1 --- z <br /> t/' Y-3 70 S � �' y ? • 31 <br /> y� <br /> 70 <br /> Sample appearance: Lock: <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 />