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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: UltraMaar Sampling Date: - <br /> Site: Beacon 1§10 Project No. : 94-610- 1 <br /> 3300 <br /> 4-6 0- <br /> 3300 Waterloo Road Well Designation: MW- 7 <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? YE 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 v <br /> Well cover type: 8" UV 12" UV121' EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI ther <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 21' disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer _:X__Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 2" 4"4— 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Rechar a Measurement <br /> Time: $4A Time: /159-- Calculated purge: 91 <br /> Depth of well: X3.78 Depth to water: sl,.ts Actual purge: c.4.5 a <br /> Depth to water: <br /> Start purge: 10 5 0 Sampling time:. t-LOO <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1/00 70, 7JJ4 <br /> ! O <br /> s 7►4 Lf <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 /> i <br /> Signature: <br />