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f <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: <br /> • <br /> Site: Beacon #641 Project No. : 98-641.-01 <br /> 0 East Hamme Lane Well Designation: V w <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? (96YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? N9 If no, see remarks <br /> Height of well. casing riser (in inches) : t' 8" BK <br /> Well cover type: 8" UV 12" "UV 12EMCO <br /> 12" BK 12" DWP 'Ve"'�CNZ_ �6" CNI� other <br /> General condition of wellheadL"a`ssembly: Excellent 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: 21179" <br /> 4n 691 $n <br /> Purge Vol. Multiplier: 0. 16 0.65 1. 47 2 . 61 gal/ft. <br /> Tni&ial 1, eas eme t ech e e e ent <br /> ,� <br /> Time: Calculated purge: <br /> Time:, — q/ Actual purge: — <br /> Depth of well: ` 3 Depth to water: <br /> Depth to water: 1 D_ <br /> Start purge:, 3 �_/ 6 Sampling time: 3 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 <br /> 3 : � � � 2 •�f // � 7 . 3 Z ---� � <br /> Iq <br /> 6- 2 7 0 7Le/ - 3 <br /> 62 • / 6 7 Z7 <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 />