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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 7 <br /> • <br /> Site: Beacon #695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation:--KW---1-1-- <br /> Lodi . <br /> esignation:_ MW----1- <br /> Lodi CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? S 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" DWP �Z'1CNI A 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" 411 _ Sit <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> iInitial Measurement Recharge Measurement <br /> Time: l Time:=7 Calculated purge: 2 5 <br /> Depth of well: 76.yq Depth to water: 6 F 1?3 Actual purge: �-- <br /> Depth to water: S <br /> Start purge: 6 d Sampling time: 7 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 6 o z 771 � � <br /> 6 51;( 6 9,1- i 5 <br /> a 74 <br /> c- 3 <br /> `7O 6 •g / 73 Ly <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 />