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DOULOS ENVIRONMENTAL -OMPANY SA1 SING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: Z <br /> Site: Beacon #641 Project No. : 8-641-0 <br /> M w_ �2— <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? 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 /> + I n <br /> Height of well casing riser (in inches) : " � <br /> Well cover type: 8" UV12" W 12n EMC HK <br /> Z g�1 ! a N1 G� <br /> 12" BK 12" DWP _ 12" CNI 36 CNI�_ her <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer TCentrifugal pump <br /> Sampled with: Disposable bailer:__2L__ Teflon bailer: <br /> Well Diameter: 2" 4"--- 6r' 8i+ <br /> 0. 65 1.47 2 . 61 gal/ft. <br /> Purge Vol. Multiplier: 0. 16 Re har a Measurement Initial Measurement Calculated purge: I q ` ! �.:R <br /> 'Z- ' Time:— 3 3 <br /> 7 1 b Depth to water• .2 v Actual purge:---T,-- <br /> Time: ar I <br /> Depth of well: { P <br /> Depth to water: <br /> Start purge: <br /> ' Sampling tame: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3 -IS -7, 0 01 FS -7 -7 , <br /> `7 , '5 <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" Lacking Cap: Lock-Dolphin:. 9/16 Bolt:— <br /> 6" Locking Cap' Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />