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4 <br /> D0UL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar _ Sampling Date: <br /> Site: Beacon #610 _ Project No. : 94-612_.41_ <br /> 3300 Waterloo Road Well Designation: MW- J <br /> Stockton, CA <br /> Is setup of traffic control devices required? N YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? E If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : ._I <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BKS_ <br /> 12" BK 12" DWP 12" CNI 36" CNI then .1) <br /> General condition of wellhead assembly: Excellent oo 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: Disposal bailer: --r Teflon bailer: <br /> Well Diameter: 2" 411_.N- 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> • Time: fil Time: 93 Calculated purge: I1, <br /> Depth of well: Depth to water: Actual purge: <br /> Depth to water: ,5 <br /> Start purge:1 (1 )Q Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> (A 15 1.1 If <br /> Fri- <br /> 7_LT <br /> 67Sas 7,30 <br /> Sample appearance: CA Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead• <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: _ _ - <br />