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t _ SAMPLING INFORMATION SHEET <br /> Client Ramage Evniromental _ Sampling Date - <br /> Site AG Manteca Project No <br /> 392 South Moffat Boulevard Well Designation R <br /> 1Manteca, CA <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut lever NO e If no,see remarks <br /> Is well cap sealed and locked9 30 NO If no,see remarks <br /> Height of well casing riser(in inches) <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"M&D 12"M&D 12"DWP <br /> 12" , 1 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 bailer Centrifugal pump <br /> Sampled with Disposable bailer _ Teflon bailer Disposable Tubing <br /> Well Diameter 2"� 4" 6" 8" <br /> M Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement / <br /> Time /Z=,-30 Time -VO Calculated purge z CD <br /> Depth of well 2 Depth to water Actual purge ►. �] <br /> Depth to water / <br /> Start purge 3 Sampling time <br /> Time Temperature E C pH Turbidity Volume <br /> -7. S, . <br /> 7i7 <br /> 1 <br /> Sample appearance Lock l <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7132 Allenhead <br /> 4"Locking Cap Lock-Dolphin 9/16 Bolt, <br /> 6" Locking Cap Pinned Allenhead (DWP) <br /> Remarks uv< /All $ <br /> A� <br /> Signature <br />