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6 <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling <br /> site: Beacon 474 Project No. : 94-474-01 <br /> 3440 East Main Street Well Designation: <br /> - <br /> Stockton CA <br /> Is setup of traffic control devices required? ® YES time: hours <br /> Is there standing water in well box? NO Above TOC B ow <br /> Is top of casing cut level? NO E If no, see remarks <br /> is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : 36 " <br /> Well cover type: 8". UV 12" UV 12" EMCO 8" BK <br /> 12" BK 121' DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent Goo 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 /> Well Diameter: 2" 4" _ 6" 81" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 .61 gal/ft. <br /> Initial Measurement Recharge Measurement Calculated purge:� <br /> Time: ; 15 _ Time: <br /> Depth of well: —.'17 Depth to water: 7100 - Actual purge: 17 <br /> Depth to water: '7(.39 <br /> Start purge: Leal Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> � o <br /> Sample appearance: Cyde.A� 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: f ` <br />