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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date:_ �"3-3 `1 <br /> . Site: Beacon #695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation: Mw-- L ] <br /> Lodi CA <br /> Is setup of traffic control devices required? YES time. hours <br /> Is there standing water in well box? I 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 If no, see remarks <br /> Height of well casing riser (in inches) : _ .3 <br /> Well cover type: 8" W 12" W 12" EMCO 8" BK <br /> 12" BK 12" DWP_�2C 12" CNI 36" CNI her <br /> General condition of wellhead assembly: Excellent 2A <br /> 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" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br />• <br /> Time: /64f7 Ti-me '7- 1 _ Calculated purge: 1J 7 <br /> Depth of well: G V',_ _ Depth to water: s 'S Actual purge: 07 g <br /> Depth to water: 6Z 3.f_ <br /> Start purge: J- Sampling time:_/�-] <br /> Time Temp. E.C. pH Turbidity Volume <br /> 2171-- <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 />