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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATIQN SHEET <br /> Client - Ultramar Diamond Shamrock Sampling Date ,- <br /> 3-=L-Site, Beacon 1641 Project No. : 98-641.-01 <br /> 1210 East Hammer Lane Well Designation• M LAS r 3 <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time• hours <br /> Is there standing water in well box' Y Above TOC Below TOC <br /> Is top of casing cut level's If no , see remarks <br /> Is well cap sealed and locked ND 9 If no, see remarks <br /> Height of well casing riser ( in inches) : <br /> Well cover type: 8" UV 12" W_ 12" EMCO 8" BK <br /> 12 " BK 12" DWP 12" CNI 36" CNI her <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:-X, Teflon bailer : <br /> Well Diameter: 2" 4" 6" Big- <br /> Purge <br /> "Purge Vol . Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> initialease eme t Recharge Measurement o 3 <br /> Time: 6 3 Time: O Calculated purge <br /> Depth of well . 7 y 7S Depth to water: 3 Actual purge : <br /> Depth to water• <br /> Start purge: 7 - i O Sampling time: 7` Y/ <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 3 17 3 7 - <br /> -7 . 3ti 27a 7 <br /> ? ' 31S& 2 G! I 7 . 8 ---- 3 <br /> 3 'f 7 2 3 ~ <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 />