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SAMPLING INFORMATION SHEET <br /> Rama m <br /> a Environmental g .,. _.._ Sampling Date <br />' Site San Joaquin County CourthouseProject No <br /> 2222 East Weber Avenue Well Designation <br /> Stockton CA <br /> Is setup of traffic control devices required9 YES time hours <br /> Is there standing water in the well boxy S VUR 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(m inches) _13 <br /> Well cover type 8"or 12"UV 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' s <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" g)y <br />' Purge Vol Multiplier 016 065 1.47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time Z D Time :p F� Calculated purge <br /> Depth o well 'Z- �Ofl Depth to water Actual purge :5 <br /> Depth tj water l-5 '$'S ^ " <br /> tart purge Sampling time <br /> :le) <br /> Time <br /> Temperature E C 2H TurbjqLty Volume <br /> ample appearance Lock <br /> quipment replaced (check all that apply) Note condition of replaced item(s) <br /> "Locking Cap Lock 7132 Allenhead <br /> "Locking Cap Lock-Dolplun 9/16 Balt <br /> "Locking Cap Pinned Allenhead (DWP) <br /> Eem ark <br /> Signatu e <br /> I <br />