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DOUL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date:��`��-g7 <br /> Site: Beacon #474 Project No. : 94-474-01 <br /> 3440 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? No If no, see remarks <br /> Height of well casing riser (in inches) - */n <br /> Well cover type: 8” UV 12" W 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI otherl�"A � <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 /> :s <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: 7!I Time: ZJ_# Calculated purge: /. <br /> Depth of well: EL,Uj„ Depth to water: .6 5� ,31----- Actual purge: //,t %r <br /> Depth to water: 64.q-5 <br /> Start purge: 74 3 Sampling time: ? S' <br /> Time Temp. E.C. ;pH Turbidity Volume <br /> 41 6y /ioi 72 � <br /> 7)-5 L4 <br /> Sample appearance: C. 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 />