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SAMPLING INFORMATION SHEET <br /> Client Ramage Environmental _ Sampling Date <br /> Site 222 East Weber Street Project No <br /> Stockton Well Designation ' '~ <br />� Is setup of traffic control devices reguired <br /> time hours <br /> Is there standing water in the well box9 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 E If no, see remarks <br /> Height of well casing riser(in inches) <br /> Well cover type 8"or 12"LTV 12"EMCO 8"or 12"BK 8"Chnsty <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 Farr Poor <br /> Purging Equipment 2" disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 14"PVC bailer _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 Recharlre Measurement <br />�} Time ' Y Ttrne 1 Calculated purge <br /> Depth of well - <br /> 337 Depth to water �: Actual purge 3 s <br /> Depth to water 2 Td 3 <br />' Start purge l -'1-5_ Sampling time 1/•' <br /> Time Tern eratute EC pH Turbidity Volume <br /> 1 1 -77] <br />' Lock /vt Ive-- <br /> Sample appearance <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2" Locking Cap Lock 7132 Allenhead <br /> 4" Locking Cap Lock-Dolphin 9116 Bolt <br /> 6" Locking Cap Pinned Al lenhead (DWP) <br /> Remarks <br />' Signature <br />