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z <br /> DOOL06 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> *•a� Project No. : 94-419 <br /> - �- <br /> Sampling Date: - 25 <br /> Client: UltSite, Be- <br /> 94-419-01 <br /> Well Designation: MW- 5 <br /> 2350 Waterloo Road _ <br /> Stockton CA <br /> YES time: hours <br /> Is setup of traffic control elldevices <br /> box' <br /> � Y S Above TOC Below TOC <br /> Is there standing water in well box. No if no, see remarks <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? <br /> Height of well casing Uriser (in 1inches) : x211 EMCO 8" BK <br /> Well cover type: DWP 12" CNI__ 36" CNI other <br /> 12 BK, -- -- Fair Poor <br /> General condition of wellhead assembly: Excellent <br /> X submersible pump <br /> Purging Equipment: _�,-2'* disposable bailer -�--Dedicated bailer <br /> 2" PVC bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: <br /> f Teflon bailer: <br /> Well Diameter: 2"� 4 <br /> _ Q. fi5 1.47 2 . 61 gal/ft. <br /> Purge Vol. Multiplier: 0. 16 Re a e e sureme t <br /> asu eme t Calculated purge: <br /> e � <br /> Time:, /� Time: 9 � Actual purge: ok <br /> Depth of well: S Depth to water: <br /> Depth to water• <br /> Start purge: 9 2- Sampling time: a <br /> PH Turbidity Volume <br /> Time Temp. E.C. <br /> 7 -7l <br /> 30 <br /> ,r Lock: t� <br /> Sample appearance: - <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 :__ 7/32 Allenhead: <br /> „ Lock-Dolphin:�_� 9/16 Bolt:.._ <br /> a Locking cap: . pinned Allenhead (DWP) :- <br /> 6" Locking Cap: <br /> Remarks: <br /> Signature: <br />