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DOULOS ENVIRONMENTAL COXPANY SAMPLING INFORMATION SHEET <br /> Client:_ U tr,amar _ Sampling Date: ,R,� 7'95 <br /> Site: Beacon 1696 Project No. : 94-696-01 <br /> 2448 West Kettleman Lane Well Designation:_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? If no, see remarks <br /> Is well cap sealed and locked? ip IP If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" W 12" W 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI _ 36" CNI Other <br /> General condition of wellhead assembly: Excellent (C'S-64 Fair Poor <br /> Nr11�w N� INNI INNS <br /> Purging Equipment: _ 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer ICentrifugal pump <br /> Sampled with: Disposable bailer•,,/ 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 Be rge -McAsurgM2nt <br /> Time: C15 Time: G n5 Calculated purge: <br /> Depth of well : 5u.4.)- Depth to water: 4 Actual purge: <br /> Depth to water: S/ <br /> Start purge: 4 4 4 Sampling time: d <br /> Time Temp. E.C. pH Turbidity Volume <br /> 734t —_ <br /> lac <br /> gas 6 710 7,453 <br /> Sample appearance. rqN,�..� 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 /> v <br />