Laserfiche WebLink
DODLOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Sampling Date• 5q 7 = <br /> • Client: Ultramar ' <br /> Site: Beacon #695 Pr03ect No. : 94-6915-01 <br /> 900 S. Cherokee Lane Well Designation: MW- 16 <br /> Lodi CA <br /> Is setup of traffic control devices required? `0 YES time: <br /> hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> If no, see remarks <br /> Is top of casing cut level? ' NO If no, see remarks <br /> Is well cap sealed and locked <br /> Height of well casing riser (in inches) : 12'• EMCO 8" BK <br /> Well cover type: 8" UV 12" <br /> 12" BK 12" DWP 12" CNI-�� 36" CNI Other <br /> General condition of wellhead assembly: Excellent Goo 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 /> Well Diameter: 2"-X- 411 6'} 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> • Initial Measurement Recharge Measurement 2- 6 <br /> Time: 5'�_ Time:— Calculated purge: <br /> Depth of well: 62.36 Depth to water: Actual purge: <br /> Depth to water: 6tl- <br /> Start purge: Ll 5 Sampling time:_to_l _ — <br /> Time Temp. E. C. pH Turbidity Volume <br /> 746 <br /> 7 Lt7 1L z <br /> 2 L4 <br /> -743 <br /> Lock: <br /> Sample appearance: <br /> -� <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Ca Lock , 3753 :` 7/32 Allenhead: � <br /> r, g p:�� Lock-Dolphin: 9/16 Bolt: <br /> 4 Locking Cap: p Pinned Allenhead (DWP) : _ <br /> . 6" Locking Cap:— <br /> Remarks: <br /> Signature: <br />