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. DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SKEET <br /> NPOWNEWN <br /> Client : Ultramar Diamond Shamrock Sampling Date: 3-` — CIO <br /> i <br /> Site Beacon 1641 Project 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 box- N Y ga Above TOC Below TOC <br /> Is top of casing cut level's NO E If no, see remarks <br /> Is well cap sealed and locked' NO CTFD If no, see remarxs <br /> Height of well casing riser (in inches) : <br /> Well cover type : S" UV12" UV 121, EMCO 8" BK <br /> 1211 BK 1211 DWP 12" CNI 3611 CNI Other 1 'Z- <br /> General <br /> General condition of wellhead assembly: Excellent Good 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:-09 Teflon bailer: <br /> Well Diameter: 2" 4" 611 811 <br /> Purge Vol . Multiplier: 0 . 16 0 . 65 1 . 47 2 . 61 gal/ft. <br /> Initial Measurement Rechar e Measurement 7 <br /> ell <br /> Time : G �� Time: Actual purge : <br /> O L Calculated purge <br /> Depth of well . -7Depth to water: <br /> Depth to waterr•�d <br /> Start purge : O e5, Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> 7 - Ye) <br /> S16 - 57 2 �al7d 7 -30 <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 /> 411 Locking Cap: Lock-Dolphin:. pinned Allenh9/16 (Bol : <br /> 6 Locking Cap: <br /> Remarks: <br /> Signature: <br />