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DOULOS_ENVIRONMENTAL, INC. �' SAMPLING INFORMATION SHEET <br /> Client ENSR Sampling Date Z r <br /> Site Stockton Scavenger_Association Project No <br /> 1240 Navy Dnve„Stockton T Well Designation <br /> r <br /> TS setup of traffic control devices required9 YE5 time hours <br /> Is there standing water m the well box9 - - - NO Above TOC Below TOC <br /> Is top of casing cut lever NO Ova If no, see remarks <br /> Is well cap sealed and locked9 NO Ift If no, see remarks <br /> Height of well casing user(minch s} <br /> V� <br /> Well cover type 8”or 12"U _ 12"EMCO S"or 12"BK 8"Christy' z= <br /> 12"Chnsty 8"M&.D _ 12"M&D 12"DWP <br /> 12" CNI 36"CNI 12"Pomeco Other ' <br /> General condition of wellhead assembly -Excellent Good Fag Poor <br /> Purging Equipment 2" disposable bailer X, : Submersible pump , <br /> 2"PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer' Disposable Tubing <br /> t <br /> Well Diameter 2" 41? 6" 8" <br /> Purge Vol Multiplier 016 0 65 147 2 61, gal/ft , <br /> Initial Measurement Recharge Measurement <br /> Time a Tune -___ _ - ` Calculated purge <br /> Depth of well t!2 Depth to water Actual purge 01 <br /> Depth to water YZr <br /> Start purge _ -2 ^ZO _ Sampling tune __—_-- <br /> 'T �T <br /> Time Temperature E C PH Turbndn Volume <br /> 72 z <br /> 2- 3 <br /> � .3 �.. 20. 7S/ <br /> Z ; 3 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"Locking Cap Lock-Dolphin 9116 Bolt <br /> 6"Locking Cap Pinned Allenhead (DWT) ' <br /> Remarks <br /> Signature. , <br />