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DOULOS ENV'IRONXEPITAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: ` -�-`�S <br /> Site: Beacon 0695 Project No. : 94--695--01 <br /> 900 S. Cherokee Lane Well Designation: MW- -2, ? <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? N 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: 811 UV 12" UV 1211 EMCO 811 BK <br /> 1211 BK 1211 DWP 12 11 CNI3611 CNT Other <br /> General condition of wellhead assemb y: Excellent qob4 Fair Poor <br /> Purging Equipment: 2t1 disposable bailer Submersible pump <br /> 211 PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer:- ,V Teflon bailer: <br /> Well Diameter: 211 41° 611 80° <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2. 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: in Time: . L.6 ! Calculated purge: <br /> Depth of well: 26,6 ^_ Depth to water: 6 7.D0 Actual purge: 7�,f _ <br /> Depth to water: <br /> Start purge: Sampling time: Zla <br /> Time Temp. E.C. pH Turbidity Volume <br /> u3 )-.L 1 <br /> 14 ? 1.10 163) <br /> l�3 <br /> 7-7,6 166 <br /> Sample appearance: a2,0� ._ Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced iters <br /> 2" Locking Cap: Lock 93753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 611 Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: :11AZ 166n:,� <br />