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DOULOS ENVIRONMENT).— COMPANY S. _FLING INFORMATION SHEET <br /> Client:—Ultramar Sampling Date:- 12-Z <br /> • Site:- Beacon #474 Project No. 94-474-01 <br /> 3440 E. Main Street Well Designation: - <br /> Stockton. CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? WAbove TOC Below TOC <br /> Is top of casing cut level? NO QZ2 If no, see remarks <br /> Is well cap sealed and locked? If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" J3K <br /> 12" BK 1211 DWP 12" CNI 3 6" CNI Other _1 � I P= c� <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailerSubmersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer- 5 F Teflon bailer: <br /> Well Diameter: 2"-X— 4" 6" 8" <br /> Purge Vol. Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> . Initial Measurement Rechame Zeasurement <br /> Time: 7 '. L-1 4 Time: #42 Calculated purge:3 <br /> Depth of well Sk (o Depth to water: 30 Actual purge: <br /> Depth to water: 421 <br /> Start purge: !i •• l Sampling time; '. 2 <br /> Time Temp. E.C. pH Turbidity Volume <br /> Loo 13 7Uo I <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 />