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DOULOB ENVIROMMITAL COMPANY SAMPLING INFORMATION SHEET <br /> Client:_ Ultramar Sampling Date: 1-13 -9-5 <br /> Site: Beacon 1610 Project No. : 94-610-01 <br /> 3300 Waterloo Road Well Designation: MW- <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? NOIf no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) . D, v � <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 3611 CNI Other <br /> General condition of wellhead assembly: Excellent QFb—o_4 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" 611 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br />. Initial Measurement Recharge Measurement <br /> Time: Time: 113! Calculated purge: f1 <br /> Depth of well: g� 3D Depth to water: -s/ 7y Actual purge: 5/ 1 <br /> Depth to water: � 1.65 <br /> Start purge: 110 Sampling time: 1140 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 6141, 517 -7 -=f 7 l <br /> 7 61,_ 66)- 7_:_11r1q - - - <br /> 61-4 <br /> Sample appearance: cAeal�'_41 Lock: 37,53 <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 /> Remarks: <br /> Signature: - •=� __ <br />