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` SAMPLING INFORMATION SHEET <br /> DOULOS ENVIRONMENTAL COMPANY <br /> Client: Ultramar Diamond Shamrock Sampling Date:., <br /> Site: Beacon 641 <br /> Project No. : 98-641--01 <br /> /V11 w - s <br /> 1210 East Hammer Lane Well Designation: <br /> Stockton CA <br /> � <br /> time• hours <br /> Is setup of traffic control devices required. � YES YES time <br /> Below TOC <br /> Is there standing water in well box'. NO � If no, See remarks <br /> bo <br /> Is tap of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? � g <br /> Height of well casing riser (in inches) : 12" EMCO 8" BKS <br /> Well cover type: $" W- 12 3611 CNI Other <br /> 12" BK 1211 DWP — CNI�_ Fair Poor <br /> e <br /> General condition of wellhad�jssembly: Excellent <br /> 211 disposable bailer Submersible pump <br /> Purging Equipment: 211 PVC bailer _Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Teflon bailer:— <br /> Sampled with: Disposable bailer:�A� <br /> Well Diameter: 2" <br /> 411 6 11 Sol <br /> 47 2 . 61 gal/ft.1. <br /> Purge Vol. Multiplier: 0. 16 0.65 /A q, <br /> t al Meas u ement Rechar a Measurement Calculated purge: I F�- <br /> Time: 3 Time: G) 7 Actual purge: - r <br /> Depth of well: Depth to water• <br /> Depth to water: 6 <br /> Sampling <br /> Start purge: - 5 time:_�C� <br /> Time Temp. <br /> E. C. pH Turbidity Volume <br /> -�10 <br /> / ) ol,�5- --,? -(�o G',� <br /> -70 , e G 9 <br /> Sample appearance: 1 <br /> _ Lock: /C-t- <br /> i ment replaced: (Check all that apply) Note condition of replaced item <br /> Equ p P 7/32 Allenhead:�- <br /> 211 Locking Cap: Lock X3753:- 9/i6 Bolt: <br /> 4" Locking Cap: Lock-Dolphin:___ <br /> b" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> I ' <br /> Signature: h <br />