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DOULOS ENVIRONMENTAIs zOMPANY SAID SING INFORMATION SHEET <br /> Client: Ultramar Sampling Date• <br /> Site: Beacon 513 Project No. : 94-513-01 <br /> q <br /> W. Kettleman Ln. Well Designation: <br /> MW_ <br /> 401 W d~ <br /> Lodi, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? Y 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) : - V <br /> Well cover type: 8u UV <br /> 12 n <br /> UV12n EMCO 8n <br /> BK <br /> 1211 BK 1211 DWP 1211 CNI - 3611 CNI her <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> Purging Equipment: 211 disposable bailer Submersible pump. <br /> 211 PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:__K_ Teflon bailer: <br /> Well Diameter: 211 411 611 art <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Rechar a Measurement <br /> Time: 4 S Time: = Calculated purge: <br /> Depth of well: 77-e2z Depth to water: ( 3 f Actual purge: - 3 q _U <br /> Depth to water: -O <br /> Start purge:-- 10: .55 Sampling time: U :: 3 O <br /> Time Temp. E.C. pH Turbidity Volume <br /> �. s 7 60- 7 '? 7 -? 7. 5 ?_ <br /> 60- 8 q 6o 7- 31 <br />{ <br /> PP <br /> Sample appearance: Lock: -� <br /> P <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 611 Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: __ i4m:�'O_t <br />