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SAMPLING INFORMATION SHEET <br /> Ramage Eviuromental Sampling Date Q. <br /> Site AG Manteca Project No <br /> 392 South Moffat Boulevard Well Designation <br /> Manteca, CA <br /> Is setup of traffic control devices required9 YES time hours <br /> Is there standing water in the well boxy 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 /> L <br /> Height of well casing riser(in inches) 6 <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8" Chnsty <br /> 12"Chnsty8"M&D 12"M&D 12"DW <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 /> 41'PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer_41 Teflon bailer Disposable Tubing _ <br /> Q„ <br /> Well Diameter 2„ 411 611 Q <br /> ' Purge Vol Multiplier 0 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement r <br /> TimeTime Q Calculated purge (A <br /> Depth of well Depth to water Actual purge <br /> Depth to water <br /> Start purge - Sampling time Q= � <br /> Time Temperature E C pH Turbidity Volume <br /> Sample appearance Lock ••�0 <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 <br /> Signature. <br />