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i <br /> DOULOS ENVIRONMENTAL COMPANY <br /> SAMPLING INFORMATION SHEET <br /> Client: Ultramar D'amondShamrock Sampling Date: IZ-3b q <br /> Site: Beacon 641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: /"'W-1 <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? NO �' If no, see remarks <br /> well ca sealed and locked? NO �3 If no, see remarks <br /> Is P f! <br /> Height of well casing riser (in inches) : 12" EMCO 8" BK <br /> Well cover type: 8" UV 12" LN <br /> 12" BK 12" DWP_ 1.2" CNI�. 36" CNI Other <br /> General condition of wellheadssembly: Excellent o 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 /> Well Diameter: 2" Y 4" 6" $" <br /> Purge Vol. Multiplier: 0. 16 0.65 <br /> 0.65 1. 47 2 . 61 gal/ft. <br /> Me su ement Recha a Measurement <br /> iTime: Calculated purge: 1-� I <br /> me: <br /> Depth of well:_ :21. 7!J _ Depth to water: 3 Actual purge:2=1-�- <br /> Depth to water: 44.03 <br /> Start purge: 359 Sampling time: 141 <br /> Time Temp. E.C. pH Turbidity Volume <br /> Lf'oc) 7 1 <br /> 730 <br /> o 7-2--f <br /> 409 a2.. <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 • 7/32 Allenhead:�_ <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br />