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SAMPLING INFORMATION SHEET <br /> ` _Ramage Environmental --- Sampling Date _z 0 - <br /> Site San Joaquin County Courthouse Project No <br /> 2222 East Weber Avenue Well Designation <br /> Stockton, CA <br /> Is setup of traffic control devices required9 Y time hours <br /> Is there standing water in the well box? NO Above TOC Below TOC <br /> Is top of casing out level? NO 92 If no,see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser(in niches) _ !Z <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"$K 8"Christy <br /> 12" Christy 8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNT 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good 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 Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 0.65 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement , <br /> Time � Time � Calculated purge <br /> Depth of well 5 ¢ Depth to water Z S` Actual purge: <br /> Depth to water Z„ 3 <br /> Start purge . Sampling time X/ 7' <br /> Time Temperature E C pH Turbidity Volume <br /> - Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7132 Allenhead. <br /> 4"Lockmg Cap Lock-Dolphin. , 9/16 Bolt: <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks <br /> Signature: <br />