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SAMPLING INFORMATION SHEET <br /> Client- Ramage Env Sampling Date M ` <br /> Site- Stockton Metro Airport _ Project No <br /> ` Stockton Well Designation <br /> Is setup of traffic control devices required? YES time _hours <br /> Is there standing water in the well box? WA YZ Above TCC Below TCC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked? NO kp 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"Christy8"M&D� 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assernbly Excellent Good Fair Poor <br /> Purging Equipment 2"disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4"PVC bailer C 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 16:19 Time - Calculated purge <br /> Depth of well Depth to water Actual purge .t0 <br /> Depth to water 50- <br /> Start <br /> DStart purge Jr— Sampling time <br /> Time Temperature E C pH turbidity Volume <br /> /4W- 3 <br /> Sample appearance. 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 ly 9/16 Boit <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> ' Remarks <br /> Signature <br />