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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon 474 Project No. : 94-474-01 <br /> 3440 E. Main Street Well Designation:_ MW- 31- <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? �9 YES Above TOC Below TOC <br /> Is top of casing cut level? NOIf no, see remarks <br /> Is well cap sealed and locked? NO YE If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" " LT <br /> yUV 12V 12" EMCO $" B <br /> 12" BK 12" DWP 12" CNI 36" CNZ Other <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 Centrifugal pump <br /> k" — <br /> Sampled with: Disposal bailer: ` Teflon bailer: <br /> Well Diameter: 2" 4"j. 6" 8" <br /> Purge Vol. Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> . Initial Measurement Rechaa Measurement <br /> Time: 4� Time: r v Calculated purge: <br /> Depth of well: 7 �� Depth to water--. 7r- �" 7 Actual purge.T�'�, <br /> Depth to water:_ <br /> Start purge: q: 3 y Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> a <br /> Sample appearance: �� C �-` `"f Lock: <br /> Equipment replaced: (Check all that apply) Note conditi 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 /> J f � <br /> Signature: �I <br />