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DOULOS ENVIRONMENTAL INC. 'SAMPLING INFORMATION SHET <br /> Client ENSR y Sampling Date <br /> Site Stockton Scavenger Association Protect No ' <br /> 1240 Navy Dnve„Stockton Well Designation <br /> T, d,,,.. of+raffr Confrnl devices reaunred? time hours <br /> Is there standing water in the well box9 - NO - 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 orches) <br /> Well cover type 8”or 12"UV 12"EMCO_ 8" or 12"BK 8"Chnsty <br /> 12"Christy 8"M&D _ 12"M&D 12"DNP ' <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Fau Poor <br /> Purging Equipment 2" disposable bailer jZ Submersible pump ' <br /> 2"PVC bailer Dedicated bailer <br /> 4"PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer ' Disposable Tubing X— ' <br /> Well Diameter 2" 4" _ 6" g„ <br /> Purge Vol Multiplier 016 065 <br /> 1 47 2 61 gal/ft ' <br /> Initial Measurement Recharge Measurement z <br /> Time " Time Calculated purge <br /> Depth of well Depth to water Actual purge > <br /> Depth to water / - Zi I <br /> Start purge .Z_=Jr- fl T _Sampling lime <br /> Time Temperature EC PH Turbidity Volume ' <br /> Z - <br /> �.3 0 z 1 �- <br /> i <br /> Lock <br /> Sample appearance <br /> , — ' <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"Locking Cap Pinned A1lenhead (DWP) ' <br /> Remarks • <br /> Signature' <br />