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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br />Client: Ultramar Sampling Date: _Z S' <br />Site: Beacon 610 Project No.: 94-610-01 <br />3300„Waterloo _Road Well Designation: -6 <br />Stockton, CA <br />Is setup of traffic control devices required? YES time: hours <br />Is there standing water in well box? YES Above TOC Below TOC <br />Is top of casing cut level? a <br />lJ If no, see remarks <br />Is well cap sealed and locked? NO I€ no, see remarks <br />Height of well casing riser (in inches):_ g <br />Well cover type: 8” UV 12" W 12" EMCO 8" BK <br />12" BK 12" DWP 12" CNI 36" CNI ler� e� <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: Disposable bailer:—t— Teflon bailer: <br />Well Diameter: 2" 4" 6" 8" <br />Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 gal/ft. <br />Initial Measurement Recharge Measurement <br />Time: e&W- Time: azo -1 Calculated purge: <br />Depth of well: fr t. 7 Depth to water: !L102— 02 Actual purge: 2W+ f fi <br />Depth to water: ?'53r-) <br />Start purge: 905 Sampling time: 1141 <br />- <br />Time <br />Temp. <br />E.C. <br />pH <br />Turbidity <br />Volume <br />203 <br />6U,7L <br />l <br />2J7 <br />�� <br />3 <br />X376 <br />L <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 />0 Remarks: <br />Signature: <br />