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SAMPLING INFORMATION SHEET <br /> Client Ramage Evniromental Sampling Date <br /> Site AG Manteca Project No <br /> 392 South Moffat Boulevard Well Designation /14 W-3 <br /> Manteca, CA <br /> Is setup of traffic control devices required? YES time hours <br /> is there standing water in the well boxy YES Above TOC Below TOC <br /> ' Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked9 NO fFJ If no, see remarks <br /> Height of well casing riser(in inches) _ i 6 <br /> Well cover type 8"or 12"W 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"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 /> ' 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 /d 3Q Time i 1`-t 4 Calculated purge 2~,2- <br /> Depth <br /> Depth of well )_7 Depth to water _ 2. 1 Actual purge ?-y1. ,J <br /> Depth to water .,3 U <br /> ' Start purge / I4 Samplmg time /I!�g <br /> Time Tem erature EC pH Turbidity Volume <br /> 11 .)--7 7--k 3 176-2- 71 <br /> 1 ' <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7/32 Allenhead <br /> 4"Lacking Cap Lock-Dolphin 9/16 Bolt <br /> 6" Locking Cap Purred Allenhead (DWT) <br /> !6emarks <br /> Signature: <br />