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DODLOS E IRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 12-"I-qI9.j <br /> Site: Beacon 9695-- Project No. : 94-695-01 <br /> 900 S. Cherokee Well Designation: Nw- /6 <br /> Lodi, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? Airm 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: 81° W 12" W 120 M4CO 810 BE <br /> 12" BK 1204 DWP 120 CNI -)e- � 3699 CNI A <br /> hw <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> Purging Equipment: 2P1 disposable bailer Submersible pump <br /> 211 PVC bailer Dedicated bailer <br /> 414 PVC bailer ^Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 214 4t9 614 819 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: Ch 3 L. Time: IL,�Al Calculated purge: �. <br /> Depth of well. 6� -6Depth to water: 6 7.05 Actual purge: 1,1511 <br /> Depth to water: cc 61- <br /> start <br /> LStart purge: Sampling time: 150 <br /> Time Temp. E.C. pH Turbidity Volume <br /> Sample appearance: C2kc__� Lock: � � f+ <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 241 Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 611 Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature; .� _ <br />