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DOUL09 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: <br /> Site: Beacon 641 Project No. : 98-641-01- <br /> 1210 East Hammer Lane Well Designation: MIAP _ <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? If no, see remarks <br /> Is well cap sealed and locked? NO E If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 811 BK <br /> 12" BK 12" DWP 12" CNI Excellent OOthertL 4 Poor <br /> General condition of wellhead assembly: <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" <br /> 4n �� 6" all <br /> Purge Vol. Multiplier: 0. 16 0.65 1. 47 2. 61 gal/ft. <br /> JWYritial Measurement Rechar a Measurement 9 <br /> ime:jTime: L4 Calculated purge: <br /> Depth of well: 7 L 6 ! Depth to water. �-1 7 u(2Actual purge: <br /> Depth to water; q Q <br /> Start purge: ' ' Sampling time:_LW _ <br /> Time Temp. E.C. pH Turbidity Volume <br /> zL6 3-2- ll 741 <br /> X33 6 you 7 3 <br /> L-4-3 7 6 , 714 <br /> Sample appearance: s Lock; <br /> �� <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 :_ 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) :. <br /> • Remarks: <br />