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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon 16.95 Project No. : 94--695-01 <br /> 900 S. Cherokee Lane Well Designation: MW- -2-i <br /> Lodi , CA <br /> Is setup of traffic control devices required? <0 YES time: hours <br /> Is there standing water in well box? 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 E If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 811 UV 12" UV 1211 EMCO 811 BK <br /> 1214 BK 1211 DWP 12" CMI 3611 CNI ther <br /> General condition of wellhead assembly: Excellent o Fair Poor <br /> Purging Equipment: _ / 214 disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump - <br /> Sampled with: Disposal bailer Teflon bailer: <br /> Well Diameter: 214X 414 614 80 <br />. Purge Vol. Multiplier: 0. 16 0. 65 1.47 2. 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: FUTime: 2.0 - Calculated purge: 1 <br /> Depth of well: -3 Depth to water: 65 .9 2. Actual purge: �. <br /> Depth to water: &91d_ <br /> Start purge: 1145 _ _ _ . Sampling time: 2Oy <br /> Time Temp. E.C. pH Turbidity Volume <br /> 147 8 l <br /> 0 1661 <br /> r 6 3 J_ !1- / 7-1 U_ <br /> Sample appearance: clea-A-.Z Lock: G� <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 93753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: , <br />