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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon #419 _ TT Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW- <br /> Stockton, CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? 1t YES Above TOC Below TOC <br /> Is top of casing cut level? NO XT if no, see remarks <br /> Is well cap sealed and locked? NO XP If no, see remarks <br /> Height of well casing riser (in inches _ <br /> Well cover type: 8" UV 12" UV' 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent oo Fair Poor <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 ba ler: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time. 174J� Time: Q� Calculated purge: Z.13 <br /> Depth of well: Depth to water: =' „� Actual purge: /-L-6 <br /> Depth to water: <br /> Start purge: �'/O Sampling time: �-- 6 <br /> Time Temp. E.C. pH Turbidity Volume <br /> /Z 7o 1,� 75V <br /> ?115 Ic ell E'5 <br /> �f7S' B a ?�1 IAF <br /> 76 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) :,_ <br /> Remarks: <br /> signature: <br />