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DOULOS ENVIRONMENTAL -OMPANY SAi ,ING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date:_ <br /> Site• Beacon #641 Project No. : 98-641-0 <br /> 1210 East Hammer Lane Well Designation:,_ <br /> r-1 W- 3 <br /> Stockton CA <br /> hours <br /> Is setup of traffic control devi.cesrequired? YES Above•TOC Below TOC <br /> Is there standing water in well box.' If no, see remarks <br /> Is top of casing cut level? NO CyFc <br /> If no, see remarks <br /> Is well cap sealed and locked? NOg <br /> Height of well casing riser (in inches) : <br /> �� 12 11EMCO— 8�� BK <br /> Well cover type: 8" UV— 12 UV 36" CNI� Other <br /> 12" BK 12" DWP� 1211 CNI, Fair Poor <br /> General condition of wellhead assembly: Excellent a� <br /> 2" disposable bailer - Submersible pump <br /> Purging Equipment: 211 PVC bailer Dedicated bailer <br /> �4" PVC bailer �—Centrifugal pump <br /> Sampled with: Disposable bailer:— .- <br /> Teflon bailer: <br /> Well Diameter: 2" 4 600 all <br /> bS i.47 2 . 61 gal/ft. <br /> Purge Vol. Multiplier: 0 . 16 O. 20 �, <br /> InIS ' a Measureme t Rechar a Measurement Calculated purge: �p <br /> Time:? to g Time:--- <br /> ime: - 5 G Actual purge:�� q <br />.Depth of well: �`� Depth to water: <br /> Depth to water• <br /> Start purge: 3 "' I ( _ Sampling time• y <br /> Time Temp. <br /> E.C. pH Turbidity Volume <br /> r _6p 7 < < l I -7 , 4 � Z <br /> 7 7 <br /> Lock: <br /> Sample appearance. <br /> ^'y^ <br /> Equipment replaced: (Check all that apply) Note condition ll replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 9/16 Bolt:,_ <br /> Lock-Dolphin: 9/16 Bolt: <br /> 4" Lacking Cap: pinned Allenhead (DWP) : <br /> 6" Locking .Cap: - <br />• Remarks: <br /> Signature: ` <br />