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DOULOS ENVIRONMENTAL COMPANY SAM, ,NG INFORMATION SHEET <br /> Client: Ultramar Diamond Shamroc Sampling Date: 6 -6-oQ <br /> s <br /> Site: Beacon J641 Project No. : 98-641.-0 <br /> lZIO East .,a„Tcr T arZp wQ11 Designation: <br /> Stockton CA <br /> Is setup of traffic control devices requireO YES time: hours <br /> d? <br /> Is there standing water In well box? 9: <br /> S Above TOC Below TOC <br /> Is top of casing cut level? 700 <br /> If no, see remarks <br /> Is well cap sealed and locked? E If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV12" UV_ 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other 12, -7= <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: T Teflon bailer: <br /> Well Diameter: 211 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2 . 61 gal/ft. <br /> Initigl Measurement Recharge Measurement 17 3 <br /> Time: Y3 Time: = 3 Calculated purge: <br /> Depth of well. SS 0 ,2 Depth to wa er: Actual purge:q <br /> Depth to water: <br /> Start purge: 3 20 Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> 3' .� / 70 . 6 y tD 7- 9d ----� t <br /> 3 . 23 G ' - 5' <br /> 3 25 Gq - o Jf ya 7- 11 <br /> Sample appearance: G+-tr_ 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 /> Signature: <br />