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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> 0 Client: Ultramar Sampling Date: <br /> Site: Beacon #419 Project No. :-94-419-01 <br /> 2150 Waterloo Road Well Designation: MW- <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? A YES Above TOC Below TOC <br /> Is top of casing cut level? NOIf no, see remarks <br /> Is well cap sealed and locked? NO � If no, see remarks <br /> Height of well casing riser (in inches) : - <br /> _ <br /> Well cover type: 8" W 12" � '"EX <br /> UV _ 12CO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent ood Fair Poor <br /> MENOMMEMMOMW <br /> Purging Equipment: 2" disposable bailer eX, Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:_WL_P Teflon bailer: <br /> Well Diameter: 2" 4"._ b" 8" <br /> Purge Vol. Multiplier: 0. 16 _ 0.65 1. 47 2. 61 gal/ft. <br /> Measurement Rechargg Measurement <br /> Time: 7 Time: Calculated purge: S <br /> Depth of well: 7 G Depth to water: ` Q Actual purge: <br /> Depth to water: <br /> Start purgeS S _ Sampling time: <br /> :•_ <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition 61f replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: - •- <br /> Signature: <br />