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DOULOS ENVIRONMENTAL,INC. SAMPLING INFORMATION.SHEET <br /> Client Delta Env Sampling Date ose <br /> Site 2537 Waterloo Rd (100966) Project No <br /> Stockton, CA Well Designation W l <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well boxy 4W YM Above TOC Below TOC <br /> Is top of casing cut level? NO If no,-see remarks <br /> Is we11 cap sealed and locked? NO tag If no,see remarks <br /> Leight of well casmS riser(m orches) <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Chmsty <br /> 12"Chnsty 8"M&D 12"M&D,;�e7, 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Parr Poor <br /> Purging Equipment 2" disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4"PV'bailer Centrifugal pump <br /> Sampled with Disposable bailer. Teflon bailer Disposable Tubing` <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier. 016 065 147 2 61 gal/# <br /> Initial Measurement Recharge Measurement / <br /> Time b Time = Galculated purge <tC3 <br /> Depth of well - Depth to waterC,Z . V ' Actual purge <br /> Depth to water t , <br /> Start purges r' Sampling time r <br /> Time Temperature E C PH Turbidity Volume <br /> el 0 <br /> Sample appearance Lock 7 <br /> Equipment replaced (che k all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7132 Allenhead <br /> 4"Locking Cap Lock-Dolphin. 9116 Bolt, <br /> 6"Locking Cap Pinned.Allenhead(DWT) <br /> Remarks <br /> Signature; <br />