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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATIDIV79HEERET <br /> Client: Ultramar Diamond Shamrock Sampling Date:, :iii ._— . <br /> Site: Beacon f641 k „ Project No. : 98-641-01. <br /> 1210 East Hammer Lane Well Designation: AW-4 <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 /> NO <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap sealed and locked? NO YD If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 811 UV 1211 UV 1211 EMCO 811 BK <br /> 1211 BK 1211 DWP 1211 CNI 3611 CNI Other/)_"r41-/} <br /> General condition of wellhead assembly: Excellent ,Good, Fair Poor <br /> Purging Equipment: 211 disposable bailer Submersible pump <br /> 211 PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: y Teflon bailer: <br /> Well Diameter: 211 4" 611 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: '�7f Time: i_�'�_ Calculated purge: <br /> w <br /> Depth of ell: 74 �Q Depth to water: _� Actual purge: Y, <br /> Depth to water: r' =t i.L <br /> Start purge:_ 3? Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> X67 <br /> 7� F, <br /> 72-1 <br /> Sample appearance: Lock: c � E./a <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock 13753 : 7/32 Allenhead:_ <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />