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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: -7 2 to ' & <br /> Site: Beacon #419 _ _ Pro3ect No. : 94-419-01 <br /> 2350 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 YF.S Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : 1� <br /> Well cover type: 8" UV 12" UV 12" EMCO ✓ 8" BK <br /> 12" BK 12" DWP 1211 CNI 36" CNI - Other <br /> General condition of wellhead assembly: Excellent Goo Fair Poor <br /> i imp n m��i�u i�wi��nm�i��nn wmi� <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC nailer — Centrifugal pump <br /> Sampled with: Disposable bailer: ✓ Teflon bailer: <br /> Well Diameter: 2" 4" X 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: .O Time: 10 , 01 Calculated purge: 72 qa <br /> Depth of well : Z�5 ( b Depth to water: 7 319 Actual purge: ?Z , 9 <br /> Depth to water: 57 O <br /> Start purge:.__� Z�` Sampling time: o ' Q 3 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 r i b 7 o & `-- t <br /> q -39 Z , 1 .3 r Cr . U -- --- -2-- <br /> Sample appearance: 1 �~ �' 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 pCap: <br /> � Pinned Allenhead (DWP) : <br /> ,�y <br /> i <br /> Remarks: T ? L " <br /> Signature: <br />