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SAMPL . G INFORMATION SHEET <br /> Client: Ramage Environmental Sampling Date : <br /> I ; <br /> Site : SJC Garage Project No . : <br /> 130 North Hunter street Well Designation : <br /> Stockton <br /> Is setup of traffic control devices requiredT YES time: hours <br /> Is there standing water in the well box? 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 Well cover type: 8" or 12" W 12" CO 8" or 12" BK 8" Christy <br /> l2" Christy 8" M&D� 12" M&D 12" DWP <br /> 12" CN 36" CNI 12" Pomeco Other: <br /> General condition of wellhead assembly: Excellent Good_ >4, 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 _ Teflon bailer Disposable Tubing <br /> Well Diameter: 2" 4" 6" 8 " <br /> L Purge Vol. Multiplier: 0 . 16 0. 65 1 .47 2 . 61 gaUft . <br /> Initial Measurement Recharge Measurement � � <br /> E I Time: / 2 S (� Timer Calculated purge : e <br /> 1 , Depth of well : s• Depth to w t'a er: Actual purge : <br /> -1 Depth to water: <br /> Start purge: Sampling time: <br /> Time Tem erattueE.C. H Turbidity Volume <br /> Y' <br /> $� 4 <br /> ' 19" - ? ter <br /> Sample appearance: Lock: 'i'`o <br />{ <br /> 1 Equipment replaced : (check all that apply) Note condition of replaced item(s) <br /> I 2" Locking Cap : Tock: 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 />