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SAMPLING INFORMATION SHEET <br /> Ramage Environmental Sampling Date <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 required? YES time hours <br /> Is there standing water in the well boxy 4P YES Above TOC Below TQC <br /> Is top of casing cut level9 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"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12" Christy 8"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" disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> J4"PVC bailer tL Centrifugal pump <br />' Sampled with Disposable bailer _ Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br />' Purge Vol Multiplier 16 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time • /0— <br /> Time J -2 : /Q Calculated purge <br /> Depth of well as .0,0 Depth to water Actual purge <br /> Depth to water 7Fo <br />' Start purge / 2 'o Sampling time <br />' Time Temperature E C pH Turbidity Volume <br />' Sample appearancei '2 Lock _ __- <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, 9116 Bolt <br />' 6"Locking Cap Pinned Allenhead (DAT) <br /> *Remarks <br /> 1 <br /> Signature <br />