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Y <br /> Client: Ultramar Diamond Shamrock Sampling Date: <br /> Site: Beacon 641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation:, / -3 <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? qb YES Above TOC Below TOC <br /> Is top of casing cut level? N-6 M If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : /2 <br /> Well cover type: 8" UV 12" W 12" EMCO 8" BK.L_ <br /> 12" BK 12" DWP 1211 CNI 36" CNI ther <br /> General condition of wellhead assembly: Excellent oo 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:-k-- Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge -Measurement <br /> Time: Time: 2_I3 Calculated purge:1�. <br /> Depth of well: 7Cii5'I Depth to water:_ 41,140 Actual purge:A,-- <br /> Depth to water: 44 /" <br /> Start purge: Off' Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> u 7 <br /> x iC-7 <br /> Sample appearance: Lock: . <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> ` 2" Locking Cap: Lock 13753 : 7/32 Ailenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br /> 4 <br />