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n <br /> DO$LOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> 'VY Client: Ultramar Sampling Date: 1 -11 -95 <br /> 0 Site: Beacon #696 Project No. : 94-696-01 <br /> 2448 West Kettleman Lane Well Designation: MW-35 <br /> Lodi , CA <br /> Is setup of traffic control devices required? (_N' YES time: hours <br /> Is there standing water in well box? N9 ave T Below TOC <br /> Is top of casing cut level? NO I no, see remarks <br /> Is well cap sealed and locked? NOE If no, see remarks <br /> Height of well casing riser (in inches) : !Z;� <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other e"::,,",4 <br /> General condition of wellhead assembly: Excellent Goo Farr 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" k 4" 6" 8" <br /> Purge Vol . Multiplier: 0. 16 0. 65 1.. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> e: ��.'/r Time: '.,�,=! Calculated purge: <br /> th of well : i5Depth to water: i Actual purge: <br /> Depth to water: S-2. 9!� <br /> Start purge: Sampling time: 5 % <br /> Time Temp. E. C. pH Turbidity Volume <br /> t + <br /> eL <br /> Sample appearance: Biu 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 /> eemarks: <br /> Signature: Il <br />