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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 5- S <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? 0 YES time: hours <br /> Is there standing water in well box? CPJO YES Above TOC Below TOC <br /> Is top of casing cut level? NO E If no, see remarks <br /> Is well cap sealed and locked? NO YES 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 _Y 36" CNI Other <br /> General condition of wellhead assembly: Excellent M 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: Teflon bailer: <br /> Well Diameter: 2" 4t' 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial. Measurement Recharge Measurement <br /> T -ime f 1 Time: �2 .3 D Calculated purge: � <br /> Depth of well: S .c Depth to water. Actual purge; _2 <br /> Depth to water- - <br /> Start purge: f `• l o sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> N-7_27 /- 7 7C! 7- l <br /> 74 3 7. 1�6 � <br /> 5 / . 5 7. 3 3 .� <br /> S r . 7 X19 7 . n <br /> r. <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 /> i� Remarks: <br /> Signature. - <br />