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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: 2 - <br /> • Site: Beacon 64 Project No. : 98-641-01 <br /> 1214 East Hammer ane Well Designation: <br /> Stockton CA <br /> Is setup of traffic control devices required? ,r3 YES time: hours <br /> Is there standing water in well box? BOJ 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" UV12" EMCO 8" BK,� <br /> 12" BK 12" DWP 12" CNI 36" CNI Other l 2 — <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> Purging Equipment: 2" disposable bailer ><-Submersible pump <br /> 2" PVC bailerDedicated bailer <br /> 4" PVC bailer —Centrifugal pump <br /> Sampled with: Disposable bailer Teflon bailer: <br /> Well Diameter: 21+ 4"_>L— 6" all— <br /> Purge <br /> "Purge Vol. Multiplier: 0. 16 0.65 1.47 2 . 61 gal/ft. <br /> •initial Measurement Rechsjrge Measurement <br /> G Time: Calculated purge: ��' <br /> Time: <br /> Depth of well: 7 1 - G O Depth to water: ' Actual purge: O. <br /> Depth to water:9 U <br /> Start purge:��3 p Sampling time:�.;. � <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3 G • / o 7 .3® ---� Z <br /> Z2 G 7 s 7, <br /> o <br /> L = y - 9 /0 y - z 6 ---- <br /> f <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 /> " Lock-Dolphin: 9/16 Bolt: <br /> 4 Locking Cap: p <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> • Remarks: <br /> Signature: <br />