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DOUL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 1.1'JL3 -`1 <br /> iSite: Beacon #474 Project No. 94-474-01-- <br /> 3440 E. Main Street Well Designation:_ KW- 1 <br /> Stockton CA <br /> Is setup of traffic control devices required? ES time: ho s <br /> Is there standing water in well box? N Above TOC elow T <br /> Is top of casing cut level? NO Y If no, see re s <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : S _ _ <br /> Well cover type: 8" UV 12" UV :�L 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI ther <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer ,` Dedicated bailer <br /> 4" PVC bailer Jf Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 2" 4" x 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 .61 gal/ft. <br /> nitial Measurement Recharge Measurement <br /> 'ime: 1010 Time: 1 m Calculated purge: 41 4411 <br /> Depth of well: 4� I/ Depth to water: 77 0 Actual purge: Z <br /> Depth to water: 77. 113 <br /> Start purge: 1047 Sampling time: H T5 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1, <br /> f vv 76 Zt <br /> 761 <br /> _7 <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 />