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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon #696 _ _ Project No. : 94-696-01 <br /> 2448 West Kettleman Lane Well Designation: MW- <br /> Lodi, _CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Cliff <br /> Is there standing water in well box? Y Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO �$' 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 1211 CNI 36" CNI Other <br /> General condition of wellhead assembly• ent Good 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: Disposal bailer: X Teflon bailer: <br /> Well Diameter: 2" 41' 6"-2—( 8" <br /> Purge Vol. Multiplier: 0.16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Wime: 6 _ Time: 3 S3 Calculated purge: 9 <br /> epth of well: -5 4•�-� Depth to water: _ 91 Actual purge: <br /> Depth to water: <br /> Start purge: 1 = S Sampling time: 3 5 S <br /> Time Temp. E.C. pH Turbidity Volume <br /> Sample appearance: 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 />