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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client:. Ultramar Sampling Date: ✓3` $_Q <br /> Site: Beacon #610 Project No. : 94-610-01 <br /> 3300 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? r 49 YES 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) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent 92EM Fair Poor <br /> Purging Equipment: 2" disposable bailerSubmersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: S Teflon bailer: <br /> Well Diameter: 2" 4" 6" $« <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharqe Measurement <br /> Time: I % '- I q Time: 3 = U �'7 Calculated purge: S2 ` ,fir/ <br /> Depth of well: 7"S Depth to water: �" Actual purge: " / <br /> Depth to water: • 3 <br /> Start purge: 3= 07 Sampling time:__ 3 �{ <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3 '• z Z54 4f <br /> 65 , f v �•t� 3 <br /> 3: 33 <br /> Sample appearance: 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 Cap: Pinned Allenhead (DWP) : <br />. Remarks: <br /> Signature• <br />