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r <br /> DOVILOS SId' IRON1UINTAh COKPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> 40 Site: Beacon 9695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation:_ FEWn? <br /> Lodi, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? YYS Above TOC Below TOC <br /> Is top of casing cut level? HO If no, see remarks <br /> Is well cap sealed and locked? NO ffJ If no, see remarks <br /> Height of well casing riser (in inches) : 3 <br /> Well cover type: 899 W 12" UV 12n EKCO 814 BK <br /> 12 4' BK 12 0° DWP 12 It CNI� 3611 CNI Other <br /> General condition of wellhead assembly: Excellent jZFair Poor <br /> Purging Equipment: 244 disposable bailer Submersible pump <br /> 2P9 PVC bailer Dedicated bailer <br /> 441 PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 244 ' \ 400 600 8'4 <br /> Purge Vol. Multiplier: 0. 1166 0.65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Rechhggae Measurement <br /> Time: 667 Time: L;=J Calculated purge: I3 <br /> Depth of Ewell: EF ' � Depth to hater: ��. q� Actual purge: � 3 0 <br /> Depth to water: b C..7 <br /> Start -purge: l b_E Sampling time: I� D <br /> Time Temp. E.C. pH Turbidity Volume <br /> /0 s -71 <br /> 3 <br /> Sample appearance: - - Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />