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y l <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client, Ultramar Diamond Shamrock Sampling Date : <br /> Site -- Beacon f641 Project No. : 98-641-01. <br /> 1210 East Hammer Lane Well Designation : <br /> -Stockton, --CA <br /> Is setup of traffic control devices required' 4� 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' NOE If no, see remarks <br /> Height of well casing riser ( in inches) : 7�/ <br /> well cover type: 8" UV12" UV- 12" EMCO 8" BK <br /> 12 " BK 12" DWP 12" CNI 36" CNI Other„ L 2 F021T CO <br /> General condition of wellhead assembly: Excellent oo 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"747 4" 6" sit- <br /> Purge <br /> "Purge Vol . Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft <br /> Initial Measu ement Recha a Measurement calculated <br /> easu ementcalculated purge <br /> Time : A' 3 Time: <br /> Depth of well : -7 / Depth to water:- � 3 Q y Actual purge <br /> Depth to water: <br /> Start purge: Sampling ling time: <br /> � Sam <br /> Time Temp. E. C. pH Turbidity Volume <br /> 7. 3 � <br /> 7 3v <br /> 7 S d 7 �'s a 7 <br /> sample appearance: Lock: <br /> 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 />