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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client Ultramar Sampling Date <br /> site Beacon#419 Protea No 94-419-01 <br /> 2350 Waterloo Well Designatwq MW- <br /> Stockton.CA <br /> Is setup of traffic control devices required? O YES time hours <br /> Is there standing water in well box? In YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no,we remarks <br /> Is well cap sealed and locked? NO If no,see remarks <br /> Height of well casing reser(iii inches) id I <br /> Well coves type 8"UV 12"UV 12" EMCO 8"BK <br /> 12"BK 12"DPW 12" CNl 36" CM Other <br /> General condition of wellhead assembty Excellent Good Fav Poor <br /> Purging Equipment: 2"disposable bailer Submersible pump <br /> 3"PVC batter Dedicated batter <br /> 4"PVC batter _� Cenulfugal pump <br /> Sampled with Disposable bailer Teflon bailer <br /> Well diameter 2" 4'. 6" r <br /> Purge Vol.Multiplier 016 065 147 261 SAM <br /> Initial Measureinent <br /> . Time R i J( Time q-11 Calculated purger �l <br /> Depth of well J 14 13 Depth to water 5 1 _-- Actual purge 5 4. : <br /> Depth to water 63 U <br /> Start purge ri D Sampling tune q3 d <br /> Terre Temperature E. C pH TurbAtty Volume <br /> Sample appearance Lack <br /> Equipment replaced (Check all that apply) Note condition of replaced itama <br /> 2"locking cap Lock 113753 7/32 Allenhead <br /> 4'locking cap Lock-Dolphm 9116 bolt: <br /> 6"locking cap Pinned Allenhead(DPW). <br /> Remarks <br /> Signature ?t <br />