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DOUL08 MMIRONNENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramag Sampling Date: <br /> Site: Beacon 0474 Project No. : 94-474-01 <br /> 3440 E. Main Street Well Designation: �W- ! <br /> Stock-ton,S&ock-ton, 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? No3 If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI her 1V'l PB1tjEC o <br /> General condition of wellhead assembly: Excellent CGo_Q& Fair Poor <br /> Purging Equipment: 2" disposable bailer �z Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: : 1 Teflon bailer: <br /> Well Diameter: 2" K 4" • 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge-Measurement G <br /> Time: 10 = `L Time: "? - 3S Calculated purge: <br /> Depth of well: ' Depth to water: � 7 /r9 Actual purge:4 I-A <br /> Depth to water: <br /> Start purge:--3 ' o'�­5 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> - r <br /> Sample appearance: r Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 21' Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> _ Si�ature• _ <br />