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Sent By : Ramage Environmental ; pM� 916 354 1786 ; Feb - 9 - CA a1 : 17PM ; Page 4 / 6 <br /> DOUI OSE IRONMENTA.L INC. SAMPLING INFORM TIO SAEE'I <br /> Client: Rama a Environmental Sampling Date: <br /> Site: _SJC Garage Project No . : <br /> 130 North Hunter street Well Designation: <br /> Stockton <br /> Is setup of traffic control device& to uired7YES time: hours <br /> Is there standing water in the well box? Above TOC $clow TOC <br /> 1 Is top crossing cut level? NO If no, see remarks <br /> f '{ Is well cap sealed and locked? NO if no, see remarks <br /> Height of well casing riser (in inches): <br /> Well cover type: 8" or 12." LTV 12" EMCO 8" or ] 2" BK 8" ChrislY__..,•— <br /> 12 " Cluisty� V M&DA!;�m_ 12" M&D 1211'DWP <br /> 12 " CM 36" CNI 12" Pomeco Other: <br /> General condition of wellhead assembly: Excellent= Good FairPoor,•— <br /> Purging Equipment: 2" disposable bailer Submersible purnp <br /> 2" PVC bailer Dedicated bailor <br /> i 4" P bailerCentrifugal p imp <br /> Sampled with : Disposable bailer Teflon bailer isposable Tubing <br /> Well Diameter: 2" 4" 6" _ 8" <br /> Pufge Vol, Multiplier: 0 . 16 0.65 1 .47 2 . 6 gal/ft• <br /> Initial Me� asurement Rech Measuframent b <br /> Time: �' Time: �/�/ _ Calculated purge : <br /> Depth of well : Depth to water: 2 y /. Actual purge: <br /> Depth to water <br /> Start purge: Sampling time: 1 3 - <br /> I <br /> j Time Temperature E.C. H Turbiditx V lume <br /> Sample appearance: 1 Y Lock: f i4/ <br /> Equipment replaced: (check all that apply) Note condition of replaced itcm(s <br /> 2" Locking Cap ; Lock: 7/32 Allenhead ; , . <br /> 4" Locking Cap : Lock-Dolphin: 4/16 Bolt : 1 .,, dl <br /> 6" Locking Cap : __..- . Pinned Allenhead (D WP) : <br /> i <br /> Remarks : <br /> I, Signature ; _ _. <br />