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DOULOS ENVIRONMENT? COMPANY S. .'LING INFORMATION SHEET <br /> Client: Ultramar Sampling Date:_ Z/ 10 <br /> • Site:_ Beacon i`474 _ Project No. : 94-474-9-1- <br /> 3440 E. Main Street Well Designation: MW- <br /> Stockton. CA <br /> Is setup of traffic control devices required? NO YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? 07>QY�. If no, see remarks <br /> Is well cap sealed and locked? U If no, see remarks <br /> Height of well casing riser (in inches) : f <br /> Well cover type: 8" UV 12" W_tv__ 1.2" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailer cX Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer Teflon bailer: <br /> Well Diameter: 211 <br /> --,X— 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 .62 gal/ft. <br /> Initial Measurement Rectiarge Measurement <br /> • Time: (o Time: :-2-2-- Calculated purge: ) 619" <br /> Depth of well - Depth to water: 7 Actual purge: f h Rte, J <br /> Depth to water: <br /> Start purge: . Sampling time: =Z 3 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7, T Z <br /> 4-'0 <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: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> • Remarks: <br /> Signature: <br />