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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: 6 -05;- 40 <br /> Site: Beacon 641 Protect No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: <br /> Stockton.- CA <br /> Is setup of traffic control devices required? � YES time: hours <br /> Is there standing water in well boxy S 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) : _ ±/ O <br /> Well cover type: 8" UV 1.2" UV 12" EMCO 811 BK <br /> 12" BK 1211 DWP -l-yUCNIZ:;., 36" CNI Other <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: Teflon bailer: <br /> Well Diameter: 2"A- 4" 6" 8I` <br />*Purge Vol . Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time : S Time: -7to w 412 ater: Calculated purge: <br /> Depth of well : Depth' <br /> De r ' q� Actual purge : <br /> Depth to water : <br /> -7 = cV 67 Sampling time: 7 �l <br /> Start purge: p g <br /> Time Temp. E. C. pH Turbidity Volume <br /> 7 o v 7o 31 v G/ r <br /> 7 --o2 / o °I / 7 . 25 �1 3 <br /> ?=off <br /> 7 / ' 2- <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 />