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DOULOS ENVIRONMENTA -OMPANY SA4 ING INFORMATION SHEET <br />+ Client: Ultramar Sampling Date: <br /> Site: Beacon 513 Project No. : 94-513-01 <br /> 401 W. Kettleman Ln. Well Designation: MW- <br /> Lodi, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? 2 Y 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) : 5 <br /> Well cover type: 8" UV 12" UV_� 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent 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: <br /> Well Diameter: 2" 4 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: Time: Calculated purge: S G <br /> Depth of well: ?q.3L Depth to water: d2= Actual purge: (15-C c�a <br /> Depth to water: 61. 78 <br /> Start purge: J0'.JQ J0'._ Sampling time: 10. 50 <br /> Time Temp. E.C. pH Turbidity Volume <br /> of � 843 7- 81 <br /> o: q6n• 3 g <br /> 0. 3G X0, r 8 o -7- 6.3 3 <br /> 10: 60 . 3 23 2 7.61 - - L( <br /> 09 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced .item <br /> 2!' Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> , Remarks: <br /> Signature: <br />