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.� SAMPLIN "NFORMATION SHEET <br /> Ramage Environmental _ Sampling Date: p <br /> Site: San Joaquin Countv Courthouse Project No.: <br /> 222 East Weber Avenue Well Designation: <br /> Stockton, CA <br /> 6W Is setup of traffic control devices required? 0' YES time: hours <br /> Is there standing water in the well box? NO Above TOC Below TOC <br /> Is top of casing cut level? NO; If no,see remarks <br /> �.. Is well cap sealed and locked? — NO; If no, see remarks <br /> Height of well casing riser(in inches): __ <br /> Well cover type: 8"or 12"W 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI . 12"Pomeco Other: G,J <br /> .� General condid6n of wellhead assembly: Excellent Goody Pair Poore <br /> i <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 Teflon bailer Disposable Tubing <br /> Well Diameter: 2"_ 4-- 4" 6" g� <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: �l ;Z D Time: G .�g Calculated purge: t/. t/t <br /> Depth of well: 2,6 4o Depth to water: Actual purge:. ,5 <br /> Depth to water: <br /> Start purge: 6 Sar4pling time:Ire <br /> : y <br /> Time Temperature E.C. pH Turbidity Volume <br /> i <br /> Sample appearance: Lock: 0019- <br /> Equipment replaced: (check all that apply) Note condition of replaced item(s) <br /> 2"Lacking Cap: Lock: 7/32 Alienhead: <br /> 4"Locking Cap: Loch-Dolphin: 9/16 Bolt: <br /> 6"Locking Cap: Pinned Auenhead(DWP): <br /> Remarks: <br /> w <br /> Signature: <br />