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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 24 7-25 <br /> Site: beacon 0696 __ Project No. : 24-§96-9j,_ <br /> 2418 West Kettleman Lane Well Designation: -a <br /> Lodi. CA <br /> Is setup of traffic control devices required? Ig YES time: hours <br /> Is there standing water in well box? Y S Above TOC Below TOC <br /> Is top of casing cut level? 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" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI�_--_ 36" CNI er <br /> General condition of wellhead'%ssembly: Excellent oo 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: Z Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier; 0. 26 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement RechArce Measurement <br /> Time: 6ig Time; Calculated purge: <br /> Depth of well: &,1Depth to water: 49.Zo Actual purge: Aroli <br /> Depth to water: <br /> Start purge: Sampling time: !%Z> <br /> Time Temp. E. C. pH Turbidity Volume <br /> 9 �---� <br /> 716 K4.4 W 73o ---� <br /> 7 751- 3 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> signature: <br />