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DOVLOS ENVIRONMENT"' COMPANY L 1PLING INFORMATION SHEET <br /> . Client: t a Sampling Date: c? -3©- <br /> 99 <br /> Site: Beacon 4 Project No. : 94-471--91 E. main street Well Designation: MW- 5 <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? NO If no, see remarks <br /> Is well cap sealed and locked? N� g If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV12" W_j,� 12" EMCO 8" BKS,_ <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent o Fair Poor <br /> Purging Equipment: 2" disposable bailer X _Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: SP Teflon bailer: <br /> Well Diameter: 2" 4" 6" 811 <br /> Purge Vol. Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> I ' t'a Measurement Recharge Measurement <br /> Time: 0- /0 Time: 11 r Calculated purge: -� <br /> Depth of we • � y y Depth to water:> 7' Actual purge: <br /> ll <br /> Depth to water: � 6 <br /> pq <br /> Start purge: � ? Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> � rs T1 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4 " Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />