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f <br /> DOUL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: 3 <br /> Site , Beacon t641 Project No. : 98-641-01 <br /> 1214 East Hammer Lane Well Designation: w <br /> Stockton CA <br /> Is setup of traffic control devices required' X!j�) 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? NO If no , see remarks <br /> Height of well casing riser ( in inches) : <br /> Well cover type : 8" UV12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP �rE''rq N1_� 36" CNZ Other <br /> General condition of wellhead�`'a�sembly: 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:-LL Teflon bailer: <br /> Well Diameter: 2" 4"1XI. 6" 8It <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1 . 47 2 . 61 gal/ft <br /> Initial Measurement Re har a Measurement <br /> Time: Time: Calculated purge <br /> Depth of well: 73 ' O6 Depth to water: Actual purge <br /> Depth to water• <br /> Start purge : ;49 Sampling time: � <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 / / 0 7 • S� ---� <br /> 11 ,7o TY1 <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 />