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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 6"14-96 <br /> iSite: Beacon #696 Project No. : 94-696-01 <br /> 2448 West Kettleman La nE Well Designation: MW-c-5 <br /> Lodi CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? qYES Above TOC Below TOC <br /> Is top of casing cut level? NT 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) : 6 <br /> Well cover type: 8" LTV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 41 CNI_k 36" CNI ther <br /> General condition of wellhead %ssembly: Excellent Goo 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:-4— Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> • Time: //A Time: 1-? J Calculated purge: <br /> Depth of well: S Depth to water: 5J-,06 Actual purge: / <br /> Depth to water: JQ.10 <br /> Start purge: ItS I Sampling time: 1L <br /> Time Temp. E.C. pH Turbidity Volume <br /> 71 r) 71W Z <br /> Sample appearance: � , r �- Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />