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n <br /> DOUL08 ENVIRONMENTAL COMPS SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 3`2-`�'�'�.^„ „ <br /> Site: Beacon #695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation: KWJ 0 <br /> Lodz, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? qqg 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) : <br /> Well cover type; 811 UV 1211 UV 1211 EMCO 819 BX <br /> 1219 BR 1211 DWP 12°f CNI ) ,� 3611 CNI they <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> Purging Equipment: 2f1 disposable bailer Submersible pump <br /> 211 PVC bailer TTDedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer:_ Teflonb�ailer: <br /> Well Diameter: 211 419 619 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 63 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: lq.W Time: 10.5 Calculated purge: 2.7d <br /> Depth of well: 7916 Depth to water:.a 6.7R Actual purge: .%4 <br /> Depth to water: 6677 <br /> Start purge: 1135 Sampling time: /07 <br /> Time Temp. E.C. pH Turbidity Volume <br /> / -l-zZW <br /> //S2 20 160 zS 3 <br /> 16-�24 Lt <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 411 Locking Cap; Lock-Dolphin: 9/16 Bolt: <br /> 611 Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: k5��� <br />