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4 <br /> DOflLOB ENVIRONMENTAL COMPANY <br /> SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon J419 Project No. : 94-419-02 <br /> 2350 Waterloo Road _ Well Designation: Mw- <br /> Stockton. --CA <br /> W•-Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? C:!pt� 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) : 12" EMCO 8" BK <br /> Well cover type: 8" UV1291Other I2 �a FCD <br /> I2" BK 12" DWP 12" CNI 3611 CNI Fair Poor <br /> General condition of wellhead assembly: Excellent <br /> Purging Equipment: 2" disposable bailer ,Submersible pump <br /> 2" PVC bailer .Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:_ Teflon bailer: <br /> Well Diameter: 2" 4". 611 801 <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2 .61 gal/ft. <br /> • e ha a Me su eme t <br /> Time: Measurement t Time: - 00 <br /> Calculated purge; <br /> Depth of we 1: dIVY— el' y ? Depth to water: `/,3 Actual purge. <br /> Depth to water: / • G <br /> Lf_ <br /> Start purge: <br /> Y Q Sampling time: ' 0 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 0 's3 <br /> 7. 33 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 :,_ 7/32 Allenhead:,,, <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br />