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DOULOS ENVIROKKENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Qltramar Sampling Date:- 9-D 7-13 - <br /> Site: Beacon 1y96 Project No. : 94-§96-01 <br /> 2448 West Kettleman Lane Well Designation:_ MW- 36 _ <br /> Lodi,_ CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? a YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO Y If' no, see remarks <br /> Height of well casing riser (in inches) : -C <br /> Well cover type: 8" UV12" UV12" EMCO 8" BK <br /> 12" BK 12" DWP 1211 CNI 36" CNn <br /> General condition of wellhead assembly: Excellei0ther <br /> od Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:_1L 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 <br /> Time: coy Time: � c <br /> Calculated purge: .Itl <br /> Depth of well: 2$.13 Depth to water: Actual purge: IL. Lto <br /> Depth to water: 5361 <br /> start purge.- 7P 4__ sampling time: ?Q6 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 746 g <br /> 9 1- •----- �. <br /> i <br /> 7SJ 67.3 7D 7 <br /> Sample appearance: Lock: 75 3 <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 />