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SAMPLING INFORMATION SHEET <br /> Client Ramage Envirorunental Sampling Date <br /> . Site SJC Garage Project No <br /> ' 130 North Hunter street Well Designation <br /> Stockton <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well box? XU Above TOC Below TOC <br /> Is top of casing cut level? FO If no, see remarks <br /> Is well cap scaled and locked? NO Q4 If no, see remarks <br /> Height of well casing user(in inches) <br /> if Well cover type 8"or 12"W 12"EMCO 8"or 12"BK 8"Chrisry <br /> 12"Christy8"M&D� 12"M&D 12"DWP <br /> 12"CM 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 pumpSampled with Disposable bailer�� Teflon bailer Disposable Tubing <br /> Well Diameter, 2" 4" 6" 8J3 <br /> Purge Vol Multiplier 016 065 1 47 2 61 gal/ft <br /> Initial Meg§urement Recharge Measurement <br /> Time = Time, zz:5: Calculated purge ` <br /> Depth of well a'Z b Depth to water � Actual purge <br /> Depth to water <br /> Start purge /y "5c) Sampling time cs <br /> Time Temperature /j EC H Ttirbidit Volume <br /> •�. el, <br /> Sample appearance. 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 /> 1 � <br /> Remarks l'/ t.4--tw, <br /> Signature' <br /> r <br />