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r <br /> . , 7T 1., <br /> SAMP. iG INFORMATION SHEET <br /> Client: Ramage Environmental Sampling Date : <br /> Site: SJC Garage Project No . : <br /> 130 North Hunter street Well Designation : / � - <br /> Stockton <br /> �l <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in the well box? S Above TOC Below TOC <br /> ! ! Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches): <br /> 1 i well cover type: 8 " or 12" W 12" EMCO 8" or 12" BK $ " Christy <br /> 12" Christy8" M&D _ 12" M&D 12" DWP <br /> 12" CNI 36" CNI" 12" Pomeco Other: <br /> General condition of wellhead assembly: Excellent Good 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 .ti Teflon bailer Disposable Tubing <br /> Well Diameter: 2" 4" 6" 8 " <br /> Purge Vol . Multiplier: 0 . 16 0 , 65 1 . 47 2 . 61 gal/ft. <br /> Initial Meagurement Recharge Measurement <br /> Time : /sZ 5R Time: Calculated purge: <br /> Depthof well : Depth to water: �"�d Actual purge : . <br /> Depth to water: /, - <br /> 3 Sampling time : <br /> Start purge: <br /> Time Tem erature E. C. pH Turbidity Volume <br /> t `z 'z y 110 7wX <br /> �l <br /> Sample appearance: Ci title Lock: <br /> Equipment replaced : (check all that apply) Note condition of replaced item(s) <br /> 2" Locking Cap : Lock; 7/32 Allenhead : <br /> 4" Locking Cap : Lock-Dolphin : 9/ 16 Bolt: <br /> 6" Locking Cap : Pinned Allenhead (DWP) : <br /> Remarks : <br /> I <br /> I <br /> I <br /> Signature : <br />