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DOULOS ENVIRONMENTA COMPANY S1. ?LING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site:_ Beacon X474 Project No. : -94-474-01 <br /> 3440 E. Main Street Well Designation: MW- Z <br /> Stockton, CA - <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? � Above TOC Below TOC <br /> Is top of casing cut level? NO � If no, see remarks <br /> Is well cap sealed and locked? NO g%ZB] If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 1;f" EMCO 8" BK <br /> 12" it PO BK 12" DWP 12" CNT 3610 CNI Otherls- <br /> l�^ Cs, <br /> General condition of wellhead assembly: Excellent <JJORP, Fair Poor <br /> Purging Equipment: 2" disposable bailer _ 4'( - 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" X 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharae Measurement <br /> Time:_7 : � O _ Time. = Calculated purge: A <br /> Depth of well: S ai Depth to water: -5-'ar0 1 Actual purge: <br /> Depth to water: <br /> Start purge: Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> z 3 <br /> ��- <br /> �;Z3 <br /> Sample appearance: Lock: <br /> Equipment replaced_ : (Check all that apply) Note condition of replaced item_ _ _._! <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: j <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> • Remarks: <br /> Signature: <br />