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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: r <br /> Site: Beacon #641 __ Project No. : 98-641-01- <br /> 1210 .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? 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) : J-10 - <br /> Well cover type: 8" UV 1.2" UV 12" EMCO_„_� 81r BKS <br /> 12" BK 12" DWP CNI }c 36" CNI 21ther <br /> General condition of wellheaNasembly: Excellent o � Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 21' PVC bailer Dedicated bailer <br /> 4" PVC bailer =Centrifugal pump <br /> Sampled with: Disposable bai.ler:_,X, Teflon bailer: <br /> x <br /> Well Diameter: 2" 4 a 611 811 <br /> Purge Vol. Multiplier: 0. 16 0.65 1. 47 2 . 61 gal/ft. <br /> Measurement e e e <br /> •Time: Time: Calculated purge:44. 4, <br /> Depth of well: Y 8 7f Depth to water: � - G Actual purge: <br /> Depth to water: Y S 70 <br /> Start purge: '• 2 d Sampling time: 3� <br /> Time Temp. E.C. pH Turbidity Volume <br /> 2 Z �Z 3 <br /> 41/ <br /> 4�5 7- 161 <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 />