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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: 3-31-cl_� _ <br /> Site: Beacon #641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: /y1111J`_r7 _ <br /> Stockton. CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? t YES Above TOC Below TOC <br /> Is top of casing cut level? NO � If no, see remarks <br /> Is well cap sealed and locked? NOt-6 If no, see remarks <br /> Height of well casing riser (in inches) : _ hF <br /> Well cover type: 8" UV 12" UV12" EMCO '8" BK <br /> 12" BK 12" DWP 12" CNI Sell CNI� they <br /> General condition of wellhead assembly: Ex�ellent Goo 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: X Teflon bailer: <br /> Well Diameter: 2" 410 6" 8" <br /> Purge Vol. Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: f.4T Time: )d Calculated purge: 62. <br /> Depth of well: Depth to water: LJ-gI,P-L Actual purge: SLI-,v <br /> Depth to water: L4q�q <br /> Start purge: 1 Sampling time: _ <br /> Time Temp. E.C. pH Turbidity Volume <br /> -1 / 7 Jr �^ 1 <br /> L1 7�r F <br /> q16 LJ <br /> Lir? <br /> r <br /> Sample appearance: g,_�o�c_ Lock: n <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock , 3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />