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` DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client:— Ultramar Sampling Date:_ -7 -- Z {p 9? (o <br /> Site: _Beacon #419 Project No. : 94-419-01. <br /> 2350 Waterloo Road Well Designation: MW- (0 <br /> Stockton, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? N XF.,j2 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) : ILt.If <br /> Well cover type: 8" W 12" UV 12" EMCO8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI--- <br /> her <br /> General condition of wellhead assembly: Excellent o 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:__X Teflon bailer: <br /> Well Diameter: 2" X 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> OTime: Q Z 3 Time: l Calculated purge: Z <br /> Depth of well: b (v , 1� 9 Depth to water: s Actual purge: �1 <br /> Depth to water; S -7 , o { } <br /> , <br /> Start purge: 9 Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> 1 g g �C� 7+ 7 3 <br /> J , g R 1Z . 8 1 317 �-- <br /> Sample appearance: G � D v ck Lf,� Lock: 3 -7 3 <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: 12 3 - <br /> I <br /> i <br /> i <br /> Signature: <br />