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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 5-dt 7`9 7 <br /> • <br /> Site: Beacon #695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation: MW- 2-3 <br /> Lodi CA <br /> Is setup of traffic control devices required? 19 YES time: hours <br /> Is there standing water in well box? S Above TOC Below TOC <br /> Is top of casing cut level? NO ErvaIf no, see remarks <br /> Is well cap sealed and locked? NO Im If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12 f1 UV 12" EMCO <br /> 12" BK 12" DWP�^ 12" CNI 36" CNIther <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 bailerCentrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 2"-4- 4" 6" 811 <br /> . Purge Vol. Multiplier: 0. 16 0. 65 1. . 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time• )-15 Time: 561 Calculated purge: /� <br /> Depth of well: 6 _ Depth to water: G3.�,a Actual purge: L-- ,, <br /> Depth to water: 6J Cg <br /> Start purge: L+0 S amp l i ng time: 5:6'L <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1444 1 76 7i5s j <br /> u-c��, 69 _17 3 <br /> L�45 5, L -50� 7 3 <br /> 71.5 - � <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: <br />