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{ _ SAMPLING INFORMATION SHEET <br /> Client Ramage Evniromental Sampling Date • " �'`� <br /> Site AG Manteca Protect No <br /> 392 South Moffat Boulevard Well Designation /t'ciwLl <br /> Manteca, CA <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well box's YES Above TQC Below TOC <br /> Is top of casing cut level9 NO If no, see remarks <br /> Is well cap sealed and locked9 NO Mp If no, see remarks <br /> Height of well casing riser(m inches) 26 <br /> Well cover type 8"or 12"W 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"�M&D a+frt-4 12"M&D 12"DWP <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 bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time /5-"S Time _ Z ' 3 9' Calculated purge <br /> Depth of well Depth to water -2 $r Actual purge <br /> Depth to water 2G `a3 <br /> Start purge // . Z 0 _ Sampling time 1!V <br /> Time Temperature E C H TurbidityVolume <br /> _7 s <br /> 37 7f � <br /> 22 y� 9 eta <br /> Sample appearanceLock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7/32 AlIenhead <br /> 4"Locking Cap Lock-Dolphin. 9/16 Bolt. <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks <br /> Signature <br />