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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamroc Sampling Date: <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? CAW YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> NO If no, see remarks <br /> Is well cap sealed and locked? <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" W 12" UV 12" EMCO 8" BK_ <br /> 12" BK 12" DWP ' CNI x 36" CNH. Other <br /> General condition of wellhead assembly: Excellent oo 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: S Teflon bailer: <br /> Well Diameter: 2" 4" 611 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> ement Rechaa Measuremert <br /> initial Measur : -p . <br /> Time: Time: Calculated purge <br /> ' <br /> Depth of well: Depth to water: cl 70 Actual purge: <br /> Depth to water: <br /> Start purge: 3: O�— Sampling time: 3 � � <br /> Time Temp. E.C. pH Turbidity Volume <br /> 12 r{ ' V6 1 -7 ----- <br /> Sample appearance: �w Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 :_ 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin:� 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />