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f <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date:_ <br /> Site: Beacon t641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: S — <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? IFIEMD If no, see remarks <br /> Is well cap sealed and locked? NO 42V If no, see remarks <br /> Height of well casing riser (in inches) : +fo <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWPY�d't(CNI 36" CNI Other <br /> General condition of wellh ad assembly: Excellent o Fair Poor <br /> Purging Equipment: 2" disposable bailer >r- 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" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge--Measurement <br /> Time: / = Time: Y' fO Calculated purge: <br /> Depth of well: ds Depth to water: IL Actual purge: I ' O <br /> Depth to water: <br /> Start purge: c>0 Sampling time: � • r <br /> Time Temp. E.C. pH Turbidity Volume <br /> -o3 70 • � ; i � U 72� <br /> Sample appearance: r�� .s_. Lock: <br /> Equipment replaced: (Check all that apply) Note conditi n 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 />