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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date- <br />. Site: Beacon -0695 _ Prosect No. * 94-695-01 <br /> 900 S . Cherokee Lane Well Designation. <br /> Lodz CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well boxy NN 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: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 3� 12 " CNI 36" CNIthey <br /> General condition of <br /> we assembly: Excellent Good Fair Poor <br /> Purging Equipment: 2 " disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer : <br /> I <br /> Well Diameter: 2"'.-y— 411 6" 811 <br /> Purge Vol. Multiplier: 0 . 16 0 . 65 1. 47 2 . 61. gal/ft. <br /> Initial Measurement Recharge Measurement_ <br /> Time: 11�9' Time : ;L� Calculated purge: <br /> Depth of well: Depth tto wwater. : 7 Actual purge, I~- 't <br /> Depth to water: 6 �t <br /> Start purge: 237 Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> 0 7- 10 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br />• Remarks: <br /> Signature: i' <br />