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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET y <br /> Client: Ultramar Sampling Date: 3 .31_9 <br /> Site: Beacon #474 Project No. : 94-474--01 <br /> j 3440 E. Main Street Well Designation: MW- <br /> 4 <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 If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV3 -- 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI her <br /> General condition of wellhead assembly: Excellent G000 Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: �' Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2. 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: Time: G 12.2 Calculated purge: )0)3 <br /> Depth of well: Depth to water: 6 2-63 Actual purge: Qjd <br /> Depth to water: Q.51- <br /> Start purge: 2:40 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> _O 7 <br /> rj <br /> 6F <br /> S - = vf. <br /> Sample appearance: Lock: !� t <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 /> I <br /> Signature: �� <br />