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DOUL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client. Ultramar Diamond Shamrock Sampling Date* . <br /> Site ,- Beacon 641 Project No. . 98-641-01 <br /> 1210 East Hammer Lane Well Designation w <br /> Stockton CA <br /> Is setup of traffic control devices required' YES time• hours <br /> Is there standing water in well box' YES Above TOC Below TOC <br /> Is top of casing cut level' E If no, see remarks <br /> Is well cap sealed and locked' NO ES If no, see remarks <br /> Height of well casing riser ( in inches) : f <br /> Well cover type : 8" UV _�,� 12" UV12" EMCO 8" $K <br /> 12" BK 121' DWP /,c�,j,�CN2� _ 36" CNI Other <br /> General condition of wellhead all�esembly: Excellent (To o 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"_41- 4" 6't 8" <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft <br /> Init,ial Measurement Recharge Measurement <br /> Time : -7 = ©O Time: 27 % ZO <br /> Calculated purge- <br /> Depth of well : G S O Depth to water: 3 6 Actual purge. <br /> Depth to water :_ �! 2 <br /> Start purge : s Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 3D <br /> q1 7 <br /> l� rg - / oy3 7 - 07 3 <br /> -7 4 �---- y <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 />