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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date:_ R� 7•g <br /> Site: Beacon 0610 Project No. : 94-610-01 <br /> 3300 Waterloo Road Well Designation: mw- 3 <br /> Stockton, CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? 'YES If no, see remarks <br /> Is well cap sealed and locked? NO Yfy If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: $" UV 12" W 12" EMCO 8" BK <br /> 12" BK 121' DWP 12" CNI 36" CNI ther <br /> General condition of wellhead assembly: Excellent 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: Teflon bailer: <br /> Well Diameter: 2" 4"_A _ 6" S" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> • Initial Measurement Recharge Measurement <br /> Time• Time: Itoy Calculated purge: <br /> Depth of well: 6J-fn Depth to water: Actual purge: 4,�s <br /> Depth to water: 6113" <br /> Start purge: Sampling time: IlLiQ <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1 'e / <br /> s7 a 2, <br /> �a3o 6 q 6S n <br /> Sample appearance: 'C 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: &eel <br />