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DOULO$ ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: Z - Z b 4 g 6 <br /> is Site: Beacon #419 Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW- 2— <br /> Stockton, CA <br /> Is setup of traffic control devices required? 4f[M> YES time: hours <br /> Is there standing water in well box's <9D YU Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? 'Ori If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Wel] cover type: 8" UV 12" UV 12« EMCO ✓ 811 BK <br /> 12" BK 12" DWP 12" CNI 36" CNZ -- Other <br /> General condition of wellhead assembly: Excellent Good 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 bailer: <br /> Well Diameter: 211 411 X 6" 811 <br /> Purge Vol, multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: q m Time: I 1 ' Q9 Calculated purge: c a <br />*Depth of well : <br /> Z µ 6 Depth to water: 7 , Actual �o � g <br /> Depth to water: 5 7 . 3 purge: <br /> Start purge: 1 Q 0 7 Sampling time: - <br /> -Time Temp. E. C. pH Turbidity Volume <br /> � 0 ', 1 -7 S 1250 'x , -79 1 <br /> 10 <br /> Sample appearance: G r' Lock: b <br /> w ■i <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 Capn:� Panned Allenhead (DWP) : <br /> 40 Remarks: ! ' <br /> �r r <br /> Signature: � <br />