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l <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: - <br /> • Site: Beacon f641 Project No. : 98-641-01 <br /> 2 0 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? S YES Above TOC Below TOC <br /> Is top of casing cut level? NO 0a If no, see remarks <br /> Is well cap sealed and locked? NO dTP If no, see remarks <br /> Height of well casing riser (in inches) : tfo <br /> Well cover type: 8" W 12" UV_ 12" EMCO 811 <br /> BK <br /> 12" BK 12" DWP 12" CNI _.. 36" CNI_, Other Z <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> Purging Equipment: 2" disposable bailer L Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:JP Teflon bailer: <br /> Well Diameter: 2"„�, 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> AllkTnitial Measu e t Rech e e s e ent ' 7 <br /> lawTime._( O 6 Time: - Calculated purge: <br /> Depth of well: ��' � Depth to water: �G - Actual purge: <br /> Depth to water: Y <br /> Start purge: 11Sampling time: - , 1.3- <br /> Time <br /> Time Temp. E.C. pH Turbidity Volume <br /> �C 3 . `I/ V -7 f <br /> � 3 . bio 7 • y2 <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 />