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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> ' Client: Ultramar Sampling Date: la -� 3 <br /> iSite: Beacon #474 Project No. : 94,474-01 <br /> 3440 E. Main Street Well Designation: Mw-3 <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standingwater in well box? 2 YES Above TOC Below TOC <br /> ? NO If no, see remarks <br /> Is top of casing cut level. <br /> Is well cap sealed and locked? NO E If no, see remarks <br /> Height of well casing riser (in inches 4? <br /> 12" UV,� " w <br /> Well cover type: 8" � 12 EMCO $ BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent Goo3L 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: Disposal bailer: Teflon bailer: <br /> ^ <br /> Well Diameter: 2" 4"_Y 6" g Ir <br /> Purge Vol. Multiplier: 0 . 16 0.65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharcxe Measurement <br /> Time: /a) Time: Calculated purge: <br /> Depth of well: �q f3 Depth to water: ?,F. L47 Actual purge: 31- <br /> Depth to water: 76. 31 <br /> Start purge:_ 1143 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> _JJ j <br /> I0& ZftY <br /> �. � <br /> �- 7.14 <br /> L4- 7.42- <br /> 11-03 <br /> ZtZ11-03 S o <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 />