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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client : Ultramar Diamond Shamrock Sampling Date: - r© <br /> Site : Beacon 1641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: iA-'lt <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? 0 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" UV 121" EMCO $"' BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other ( 2 <br /> General condition of wellhead assembly: Excellent 49EI 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: S� Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol . Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: / 3 ZfTime: :3 ' ! O Calculated purge <br /> Depth of well : St/ 910 Depth to water: Actual purge : <br /> Depth to water: V2 0 Y <br /> start purge : Z s Sampling time: 4 <br /> Time Temp. E. C. pH Turbidity Volume <br /> ?0- 11162 ----- <br /> S / I- /o Vs -7 � / 3 <br /> 3 00 G 9 -2 /o Yv -7 y <br /> Sample appearance : Lock: �^- <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead- <br />• 4" Locking Cap: Lock-Dolphin: 9/16 Bolt : <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks : <br /> Signature : <br />