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DOULOS ENVIRONMENTA+.1COMPANY SAPLING INFORMATION SHEET <br /> Client. Ultramar Sampling Date:,� <br /> Site: Beacon 1474Project No. : 94-474--01 <br /> 3440 E. Main Street Well Designation: W-- j <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? $0If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : 3 <br /> Well cover type: s" W 12" UV 12" EMCO 8" B <br /> 12" BK 1211 DWP 12" CNI 3 6" CNI Other i" �'a <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer p Centrifugal pump <br /> Sampled with: Disposal bailer: 5; T Teflon bailer: <br /> Well Diameter: 2" K 411 611 gu <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Rech -n mg—gureLnent <br /> Time: 7 , 3 <br /> � Time: _ [ `. (� Calculated purge:S+ <br /> Depth of well: Depth to water: Actual purge:���n <br /> Depth to water: , <br /> Start purge: 1L 0 Sampling time: l 2 - � <br /> Time Temp. E.C. pH Turbidity Volume <br /> Ji"rel lo0i 2, 71 Z� 1 <br /> CP c� 7 '2-2- <br /> 01 <br /> 2201 [ L+ 7tl S- 3 <br /> 1 G 103 &0 , -7 `�— <br /> Sample appearance: Lock: 0 <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 /> . Remarks: <br /> Signature: <br />