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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: S' L 7 <br /> Project No. : 94-695-p1 <br /> Site: Beacon 695 J <br /> 900 S. Cherokee Lane Well Designation: MW- 1? <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? No q78 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: 8" UV 12" UV 12" EMCO 81� BK <br /> 12" BK 12" DWPX. 12" CNI 36" CNI -other <br /> General condition of wellhead assembly: Excellent oo 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"-4_ 4" 6'1 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> . Initial Measurement Recharge Measurement <br /> Time• 13S Time• LAQ /� Calculated purge: , 6 <br /> Depth of well: 6 X1. 6 Depth to water: jE 1-1 Actua l purge: 6 <br /> Depth to water: SSS 5) <br /> Start purge:_<31_S _ sampling time: �- <br /> Time Temp. E. C. pH Turbidity Volume <br /> 316 4 r.L <br /> 319 6 1412- 5— 2 <br /> 31.3 / d 75� 3 <br /> d <br /> 6F. 6 i.i /-7/ <br /> 7 �f <br /> Sample appearance: -v 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: <br />