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SAMPLING INFQRMATION SHEET <br /> Ramage Evniromental Sampling Date <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 to the well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NQ If no,see remarks <br /> Is well cap sealed and locked? NO S If no,see remarks <br /> Height of well casing user(in inches) Z_ <br /> Well cover type 8"or 12"LTV 12"EMCO 8"or 12"BK 8"Chnsty <br /> 12"Christy . 8"M&D 12"M&D 12"DWI' g <br /> 12"CNI_ 36"CNI_ 12"Pomeco Other �f g <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 Centnfugal pump <br /> Sampled with Disposable bailer - Teflon bailer ""Disposable Tubmg <br /> Well Diameter 2" 4" 6" $" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Rechar e Measurement �l <br /> Time Time 6 ! Calculated purge 7 <br /> Depth of well Depth to water Actual purge <br /> Depth to water <br /> Start purge- ,t© = - `� Sampling time Z6 _3 <br /> Time Tem erature EC pH Turbidi Volume <br /> /U ZS Z <br /> c <br /> Sample appearance Lock " _ <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 9116 Bolt. <br /> 6"Lockmg;Cap Pinned Allenhead (DWP) <br /> Remarks _ ' <br /> Signature: --- <br />