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` DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> � 3 r2�- �� <br /> Client:—Ultramar Sampling Date: <br /> Site: Beacon 1412 Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW_ <br /> Stockton, CA <br /> � <br /> Is setup of traffic control devicesrequired. � YES time:_ hours <br /> YES Above TOC Below TOC <br /> Is there standing water in well box.' NO � If no, see remarks <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap seaCasined and <br /> risere(in inches) : Nf� <br /> Height of well q 12" UV 12„ EMCO 8" BKS, <br /> Well cover type: 8" UV <br /> n 36" CN I, Other <br /> 12" BK 12" DWP 12 CNI�^ t Fair Poor <br /> General condition of wellhead assembly: Excellent <br /> 2" disposable bailer Submersible pump <br /> Purging Equipment: P Dedicated bailer <br /> 2" PVC bailer <br /> 4" PVC bailer Centrifugal pump <br /> - <br /> Sampled with: Disposable bailer:_2 e- Teflon bailer:— <br /> � 6u 8"_ <br /> Well Diameter: 2"X. 4 <br /> 0.65 1.47 2 . 61 gal/ft. <br /> Purge Vol. Multiplier: 0. 16 Bechar a Me su ement <br /> Tnitial Measurement Calculated purge: �d <br /> Time: G =5 < Time: 2 . V Actual purge: v <br /> Depth of well* 3'�- Depth to water: <br /> Depth to water: <br /> Start purge: <br /> fQ Sampling time: OL 2 <br /> Time Temp. <br /> PH Turbidity Volume <br /> E.C. <br /> fo <br /> a. z7 6 °l • 3 to�i -7• <br /> Sample appearance: Loc . <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: ^ Lock `3753 : 7/32 91n <br /> / 6Bolt: <br /> 4" Locking Cap: _ r_ Lock-Dolphin: / <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br />