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DOULOS ENVIRONMENTA_ COMPANY Sf. 2LING INFORMATION SHEET <br /> Client:„ Ultramar Sampling Date: / l _ <br /> Site: Beacon #474 Protect No. : 94-474-01 <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? S Above TOC Below TOC <br /> Is top of casing cut level? O If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) <br /> Well cover type: 8" UV 12" UV_� -1-2-11 ItMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent 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" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement_ Recharge Measurement } <br /> • Time: 7 ', f � Time: = o � Calculated purge: 1 3, ! 5f r <br /> Depth of well.- 7 `� Depth to water: Actual purge: <br /> Depth to water: <br /> r�' S" <br /> Start purge: 1J ' s / Sampling time: g �� <br /> Time Temp. E.C. pH Turbidity Volume <br /> 13 &-0-- 7. 9 <br /> 0 z <br /> 7 -, 3 �� q- <br /> Sample appearance: Lock: <br /> _ .Equipment replaced:.- (Check all that apply) Note .condition of _replaced item <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> iRemarks: <br /> Signature: <br />