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SAMPLING INFORMATION SHEET <br /> Client Ramage Evniromental Sampling Date _ 1`1-�J-�q <br /> Site AG Manteca Project No <br /> ' 392 South Moffat Boulevard Well Designation- /14 - <br /> ' Manteca, CA <br /> Is setup of traffic control devices required? O YES tune hours <br /> Is there standing water in the well box? S 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(m inches) <br /> ' Well cover type 8"or 12"W 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy8"M&D�_ 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 /> ' <br /> 4"PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer ^ Teflon bailer isposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Rechartre Measurement <br /> Time 10 3-14t Tame /1 Z 1 _ Calculated purge c�•, <br /> Depth of well Depth to water Actual purge }..3t- •j <br /> Depth to water � ).,a•3 <br /> Start purge Sampling time !/ f <br /> ' Time Temperature E C pH Turbidity Volume <br /> 771 <br /> ' Sample appearance Lock f� <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 9/16 Bolt <br /> ' 6"Locking Cap Pinned Allenhead (DWP)- <br /> emarks <br /> Signature' <br />