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i " r" <br /> DOULOS ENVIRONMENTAX OMPANY SA'3ING INFORMATION SHEET <br /> s Client: Ultramar Sampling Date: ) -�6 <br /> Site: Beacon 513 Project No. : 94-513-01 <br /> 401 W. Kettleman Ln. Well Designation: MW- 3 <br /> Lodi CA <br /> Is setup of traffic control devices required? <0 YES time: hours <br /> Is there standing water in well box? dZ YES Above TOC Below TOC <br /> Is top of casing cut level? NO <22a If no, see remarks <br /> Is well cap sealed and locked? NO� If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" W 12" W��� 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 O 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Rechar a Measurement <br /> _ { Time: Time: Calculated purge: <br /> Depth of well: 74 . 31 Depth to water: 61 I Actual purge: <br /> Depth to water: a <br /> Start purge: sampling time: 15 r _ <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1 3 6 7 9 5 7- 51 `---- 1 <br /> r q0 C1 it D 7_L/ <br /> 11- 3 733 <br /> 7.3 a <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 />