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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultram r Diamond Sha mr ck Sampling Date: - � ^ <br /> Site: Beacon J641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: y w <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? A 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) : 1 !> <br /> Well cover type: B" UV12" UV12" EMCO 8" BK <br /> 12" BK 12" DWP ' NY 36" CNI Other <br /> General condition of wellhead'�a"ssembly: Excellent e4m9A 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 /> _�� " �� 8 u <br /> Well Diameter: 2'+ 4 6 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Rechara Measurement <br /> Time: 2 Time: 3 " Z Calculated purger <br /> Depth of well: J Depth to water: 7 Ea Actual purge: <br /> Depth to water: Ll <br /> Start purge:_3 1 Sampling time• 3 - C <br /> Time Temp. E.C. pH Turbidity Volume <br /> i <br /> (. 1 <br /> r j <br /> J <br /> Sample appearance: 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 />