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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> a <br /> Client: °� - 17 - 9q <br /> Ultramar Sampling Date. <br /> Site: Beacon _1695 Project No. 94-6 -01 <br /> I900 S. Cherokee Lane Well Designation: 7 <br /> Lod i—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? NO If no, see remarks <br /> Is well cap sealed and locked? NO �Fs If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 811 UV 12" UV 12" EMCO 8" BK <br /> 1210 BK 12" DWP 12" CNI X 36" CNI Other <br /> General condition of wellhead assembly: Excellent _?OPFair 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 /> Well Diameter: 211 X 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> rTime: Time:. 1 10 Calculated purge: 5 <br /> Depth of well: _75. 9 6 Depth to water: 74 6 1 Actual purge: 3 <br /> Depth to water: 70- 45 <br /> (� <br /> Start purge: 1 -7- Y s Sampling time: 15 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 19- 9 q 7 9 -7- 56 ------ <br /> -5 <br /> �5 f 1 . ,3 7 gH 7 - q 7 <br /> � . 5q 69 7 7 72 -7- 3 ,e -� 3 <br /> 1 05 6 � • 9 7�6 7 3,2 --^ <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753: 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> signature: <br />