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SAMPLING INFORMATION SHEET <br /> � d <br /> Client Ramage Evmromental Sampling Date <br /> _ Sa <br /> Site AG Manteca Project No <br /> ' 392 South Moffat Boulevard Well Designation / Llf- " <br /> Manteca, CA <br /> is setup of traffic control devices required YES time hours <br /> Is there standing water m the well box? YES Above TOC Below TOC <br /> Is top of casing cut levei9 NO If no,see rernarks <br /> Is well cap sealed and locked9If no,see remarks <br /> Height of well casing riser(in inches) NO <br /> Well cover type 8"or 12"LW 12"EMCO 8"or 12"BK 8" Christy <br /> 12" Christy 8"M&D 12"M&D 12"DWP err <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Fair Poor <br /> Purging Equipment 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailerCentrifugal pump <br /> Sampled with Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 635 g„ <br /> Purge Vol Multiplier 16 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Cal <br /> Time G Calculated purge <br /> Time <br /> Depth of well Depth to water Actual purge <br /> Depth to water <br /> Sampling time l V O <br /> Start purge f <br /> Time Tein erature E C H Turbidity Volume <br /> 4/ /� zs� 1 � <br /> Sample appearance <br /> Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2" Locking Cap Lock 7/32 Allenhead <br /> 4"Locking Cap Lock-Dolphin 9116 Bolt <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks ry -0 <br /> Signature <br />