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r <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> ' Client: Ultramar Sampling Date: /0- 13 -914 <br /> Site: 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? N YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? N� E If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" W 12" UV 12" EMCO3_ 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNT ther <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 k Centrifugal pump <br /> Sampled with: Disposal bailer:-:K-- Teflon bailer: <br /> Well Diameter: 2" 411 611 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br />• Time: 1115 Time: '46 Calculated purge:�Z <br /> Depth of well: 6 Depth to water: X73 U Actual purge: 1$ 7 <br /> . <br /> Depth to water: 73.71 <br /> Start purge: 1 Ig Sampling time: b o <br /> Time Temp. E.C. pH Turbidity Volume <br /> 3L �6 <br /> 7 7 J-9 3 <br /> i y 6 7� y <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 />. Remarks: <br /> Signature: <br />