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DOULOS ENVIRONMENTAL %.OMFANY <br /> SAM. tNG INFORMATION SHEET <br /> Client: U t ama am _Shamro_Qk Sampling Date: _y <br /> Site: Beacon 64 Project No. : 98-641-01- <br /> 10 East Hammer Lane Well Designation: <br /> Mw- <br /> _t_ I <br /> Stockton CA <br /> R <br /> _ hours <br /> Is setup of traffic control devices required? YES Above TOC Below TOC <br /> Is there standing water in we13 box. NO I%$? If no, see remarks <br /> Is top of casing cut level? NO 1* If no, see remarks <br /> Is well cap sealed and locked? <br /> Height of well casing riser (in inches) : 1 EMC0 811 BKS <br /> Well cover type: 8" UV +� 12 UV�,i�NI ther <br /> 12" BK_ 12" DWP„�._ 12 CNI_ <br /> General condition of wellhead assembly: <br /> Excel3ent oo Fair Poor <br /> 2" disposable bailer Submersible pump <br /> Purging Equipment: 211 PVC bailer Dedicated bailer 411 PVC bailer _/C-Centrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> n <br /> Well Diameter: 2" 46" Big <br /> 0.65 1.47 2 . 61 gal/ft. <br />�rge Vol. Multiplier: 0. 16 Bechar a Measurement 3 <br /> t 1 easurement . 6 Calculated purge <br /> Time: Time. Actual purge <br /> Depth of we l 1: 7 Depth to water: ��- p g ' <br /> Depth to water: A55 <br /> Start purge: � 3 � _ Sampling time: 6 ± <br /> Time Temp. <br /> E.C. pH Turbidity Volume <br /> 636 <br /> 63? 71, Li- i tel- $ <br /> 6 LFb 70,J �� I <br /> Lt <br /> 6 4L ^,6, ' <br /> Sample appearance. Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> Lock #3753 : 7/32 Allenhead+ <br /> 211 Locking Cap:�� 9/16 Bolt. <br /> 4" Locking Cap: _ Lock-Dolphin:_ <br /> 6" Locking Cap: _ Pinned Allenhead (DWP) : <br /> 0 — <br /> Remarks: <br /> Signature: Llvza/�1_7 <br />