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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date:_ L26 <br /> • Site: Beacon #696 Project No. : 94-696-91 <br /> 2448 <br /> -696- <br /> 2448 West Kettleman Lane Well Designation: MW-36 <br /> Lodi. CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? N If no, see remarks <br /> Is well cap sealed and locked? NOIf no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" 12" EMCO 8" BK <br /> 12" BK 12" DWP 1.211 NIT 36" CNI ther <br /> General condition of wellhead esembly: 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 .__ Teflon bailer: <br /> Well Diameter: 211 4"4 6" 8" <br /> Purge Vol. Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> • Time: 1110 Time: JJS_q Calculated purge: 2 . <br /> Depth of well: X59.l5 Depth to water;TS D. 63 Actual purge: �.7� 1_U <br /> Depth to water: <br /> Start purge: /1 i 6 _ Sampling time: IJ 5 E <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 . 75 <br /> �2, <br /> 0 ��� 3 <br /> Sample appearance: Lock: f7i <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 />