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«,. +•,�� =tom; �,' Y.y* " s tiLMc'7r� Y'mrY'c�a „�--�.. .-.., .�.``...,r—....-._...�- , <br /> SAMPLING INFORMATION SHEET <br /> Client Ramage Environmental Sampling Date D C� <br /> Site SJC Gara e Project No <br /> 130 North Hunter street Well Designation <br /> Stockton <br /> ' Is setup of traffic control devices required? FO <br /> YES time hours <br /> Is there standing water in the well box? Above TOC Below TOC <br /> Is top of casing cut level? If no, see remarks <br /> ' Is well cap sealed and locked? F" NO If no, sce remarks <br /> Height of well casing riser(in inches) ((�� <br /> ! Well cover type 8"or 12"W 12"EMCO 8"or 12"BK 8" Christy <br /> 12"Chnsty 8"M&D_>e 1211 M&D 12"DWP <br /> 12"CM 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Goode 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 /> ' Purge Vol Multiplier 0.1 0.65 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time ?,'/_0 Time Calculated purge <br /> Depth of well IL Depth to water Actual purge <br /> Depth to water <br /> Startpurge ,,/0 7110 Sampling time <br /> i <br /> Time Tem eratme E CH Turbidit Volume <br /> Sample appearance: Lock <br /> Equipment replaced* (check all that apply) Note condition of replaced item(s) <br /> ' 2"Locking Cap Lock 7132 Allenhead <br /> 4"Locking Cap- Lock-Dolphin 9/16 Bolt <br /> 6"Locking Cap, Pinned Allenhead (DWP) <br /> Remarks <br /> Signature' _ _ <br />