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DOULOS ENVIRONMENTAL _JMPANY SAM. .LNG INFORMATION SHEET <br /> Client: Ultramar _ Sampling Date: <br /> Site: Beacon 1474 _ __ Project No. : 4-474-01 <br /> 3440 E. Main Street Well Designation: MW- <br /> Stockton, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? O fy—M) If no, see remarks <br /> Is well cap sealed and locked? N If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UVg_ 12" EMCD 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CMI Other <br /> General condition of wellhead assembly: Excellent o Fair Poor <br /> Purging Equipment: 2" disposable bailer X Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: S "P Teflon bailer: <br /> Well Diameter: 2" 4" 6" 81f <br /> Purge Vol. Multiplier: 0, 16 0. 65 1.47 2 . 61 gal/ft. <br /> AnkInitial Measurement Re harge Measurement 9_0 R- <br /> ime: 7 : 1 o Time: 1 7 Calculated purge: <br /> �L <br /> Depth of well: �S�� Depth to water: '1r Actual purge:�G�q <br /> Depth to water: Q <br /> Start purge: -7 5 Sampling time: O 9 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 . S r �' -2- 7 �. 9 <br /> 3: fo <br /> Sample appearance: [i0e g-un Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item - =-- <br />