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r <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date. <br /> • <br /> Site: Beacon 1641Project 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' Y S Above TOC Below TOC <br /> Is top of casing cut level? O If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : 12" EMCO B" BK� <br /> Well cover type: 8" "UV_ 12UV <br /> 12" BK 12" DWP j 4CNI-�_ 36" CNIOther <br /> Fair poor <br /> General Condition of wellhe4a ssembly: Excellent o <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: 2" 4" 611 $fl <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2 . 61 gal./ft. <br /> �nitlal Ne surement e h aMeasurement3, <br /> Time: Time: : moo Calculated purge: <br /> ��` DS Depth <br /> to water: Actua 1 purge <br /> Depth Of well. P <br /> Depth to waters fJ <br /> Start purge: 3 = S Sampling time: y- <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3 Z • g o �3 - Y <br /> 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 />