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SAMPLING INFORMATION SHEET <br /> Client Ramage Environmental Sampling Date 0Y <br /> lieSite SJC Parking Garage _— Project No <br /> 130 N Hunter Street Well Designation <br /> Stockton, CA <br /> Is setup of traffic control devices required9 YES time hours <br /> Is there standing water to the well boxy As Above TOC Below TQC <br /> Is top of casing cut lever Fi D If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser(in inches) G <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"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"PX bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/fl <br /> Initial Measurement Recharge Measurement <br /> Time 9, Time �/f - A 7 Calculated purge <br /> Depth of well Depth to water `Zi, 0/ Actual purge <br /> Depth to water <br /> Start putge Sampling time <br /> Time Temperature E C. PH Turbidity Volume <br /> 3 / cl <br /> Sample appearance --' Lock <br /> Equipment replaced (check all that apply) Note condition of replaced itern(s) <br /> 2"Locking Cap Lock 7/32 Allenhead <br /> 4"Locking Cap Lock-Dolphin 9116 Bolt <br /> 6"Locking Cap Pinned Allenhead (DWT) <br /> r <br /> Remarks ,�f�N -1& <br /> Signature <br />