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DOULoB ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: <br /> • Project No. : 98-641-01 <br /> Site: Beacon b4 � <br /> 98-641-01 - <br /> 1210 East Hammer ane Well Designation: <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: <br /> _ hours <br /> Below TOC <br /> Is there standing water in well box. <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) : - �-(o <br /> Well cover type: 8" UV 12" UV12" EMCO 8" BK_ <br /> 12" BK 12" DWP " NI_!_ 36" CNI Other <br /> General condition of wellhead assembly: Excellent CrtCga Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer J�Centrifugal pump <br /> Sampled with: Disposable bailer: 7L Teflon bailer: <br /> Well Diameter: 211­1�---- 4" b" 8" <br /> purge Vol. Multiplier: 0. 16 0.65 1. 47 2 . 61 gal/£t. <br /> Measurement Recharge Measurement <br /> ime: Time: Calculated purge: <br /> Depth of well• LS O� Depth to water: y5 • `� � Actual purge. <br /> Depth to water: <br /> Start purge: Sampling time: ,. y S,S <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1 .6 11413 <br /> • �r 3 • © to 7-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 /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> . Remarks: <br /> Signature: <br />