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4 <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> iSite: 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? 90) YES time: hours <br /> Is there standing water in well box? it 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" W 1.2" EMCO 8" BK <br /> 12" BK__X_ 12" DWP 12" CNI 36" CNI her <br /> General condition of wellhead assembly: Excellent Good 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" 401-4- 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: S'-t4 Time: qj_yL Calculated purge: <br /> Depth of well: 3 d Depth to water: 5f, 'Tf Actual purge; 9 fr a <br /> Depth to water: FOX <br /> Start purger 1f q7 Sampling time: 93T/ <br /> Time Temp. E.C. pH Turbidity Volume <br /> rs 7 6 t u 4(r7 -117 1 <br /> Roy 60_- "z 73 <br /> 117 CC I L-P71 -7 3/ 3 <br /> 1727 6r.3 q,55 V <br /> Sample appearance: n l_P_.sln Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />