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DOULOS ENVIRONMENTAL, COMPANY SAMPLING INFORMATION SHEET <br />Client: Ultramar Sampling Date: <br />Site: Beaco 6 Project No.: 94-610--01 <br />3300 Waterloo Road Well Designation: MW- 7 <br />Stockton CA <br />Temp. <br />E.C. <br />pH <br />Is setup of traffic control devices required? YES <br />time: <br />hours <br />Is there standing water in well box? <br />YES <br />Above TOC Below TOC <br />Is top of casing cut level? <br />NO <br />If no, <br />see remarks <br />Is well cap sealed and locked? <br />NO Y2U <br />If no, <br />see remarks <br />Height of well casing riser (in inches): <br />'/2 <br />g <br />Well cover type: 8" W 12" UV <br />12" EMCO <br />8" <br />BK <br />12" BK 1211 DWP 12" CNI <br />36" CNIher <br />General condition of wellhead assembly: <br />Excellent <br />o Fair <br />Poor <br />Purging Equipment: _211 disposable bailer Submersible pump <br />2" PVC bailer Dedicated bailer <br />4" PVC bailer Centrifugal pump <br />Sampled with: Disposable bailer: 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 Rechar a Measurement <br />Time: —S,Time:_LL Calculated purge:_ <br />Depth of well: 3? Depth to water: Actual purge:�ai� <br />Depth to water: �,�3 <br />Start purge:. 1010 Sampling time: <br />Time <br />Temp. <br />E.C. <br />pH <br />Turbidity <br />Volume <br />/ z7 <br />03.4 , <br />C/ U? <br />23r( <br />1 <br />o <br />16'r <br />7 <br />11.7 <br />r Mfr <br />g <br />J <br />ID 58 <br />1,6 <br />Sample appearance: j�,g�...._ Lock: <br />Equipment replaced: (Check all that apply) Note condition of replaced item <br />211 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 />