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SAMPLIN 'NF0RMATJ0N SHEET <br /> Ramage Environmental Sampling Date: O <br /> `r Site: San Joaquin County Courthouse. Project No.: <br /> 222 East Weber Avenue Well Designation: <br /> Stockton, CA <br /> +—+ Is setup of traffic control devices required? YES -time: hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut level? NO 450 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"AK 8"Christy <br /> 12"Christy8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI . 12"Pomeco Other: <br /> General condition of wellhead assembly: Excellent Good- Fair Poor <br /> Purging Equipment: 2"dissposable bailer <br /> `'" 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" 6" g" <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 .gal/ft. <br /> Initial Measurement Recharye Measurement <br /> Time: G S f5 Tima: 1_ ,t Q0 _ Calculated purge: 6. Z <br /> Depth of well: 2,5 _ 00 Depth tb water: 1.7— . 9.,C Actual purge:,-e— <br /> 4� Depth to water: f zip 7' <br /> Start purge: 6: y 4 Satilpling time: -7 : 02� <br /> Time Temperature E.C. pH Turbidity Volume <br /> 0 /2 <br /> sy . 6 <br /> 12 5R, 7- S/ <br /> Sample appearance: Lock: /1i A <br /> Equipment replaced: (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap: Lock: 7/32 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6"Locking Cap: Pinned Allenhead (DWP): <br /> Remarks: <br /> Signature: <br />