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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: -2 7 <br /> Site: Beacon #695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation:—ML-1-7 <br /> Lodi CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? M YES Above TOC Below TOC <br /> Is top of casing cut level? � 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 $" BI{ <br /> 12" BK 22" DWP 12" CNIX— 36" CNI other <br /> General condition of wellhead assembly: Excellent 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: L,,= Tef�JILon�bail�er:-�--.... <br /> Well Diameter: 2114— 41+ 611 8" <br /> • Purge Vol. Multiplier: 0. 1.6 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: 2-33 Time: `Id `l Calculated purge: 6-3 <br /> Depth of well: Depth to water: Actual purge: 6 <br /> Depth to water: K6 17' <br /> Start purge: `7 !.� Sampling time: 740 <br /> Time Temp. E. C. pH Turbidity Volume <br /> 7-�-6 <br /> , <br /> cs <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 />