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r <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 7 <br /> Site: Beacon g695 Project No. : 94-695-01 <br /> JzW <br /> 900 S. Cherokee Lane Well Designation: il- ` <br /> Lodi CA <br /> Is setup of traffic control devices required? goo) YES time: hours <br /> Is there standing water in well box? (U YES Above TOC Below TOC <br /> Is top of casing cut level? NO ' if no, see remarks <br /> Is well cap sealed and locked? NO EE If no, see remarks <br /> Height of well casing riser (in inches) : 6 <br /> Well cover type: 8" UV 12" W <br /> 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI�c Other <br /> General condition of wellhead assembly: Excellent o Fair Poor <br /> Purging Equipment: 2" disposable bailersubmersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer:�� <br /> Well Diameter: 21+ 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> • Initial Measurement Recharge Measurement <br /> Time: 306 — Time 3 �5� _ Calculated purge: <br /> Depth of well. R330 Depth to water: CS- ! <br /> 31 Actual purge:/ <br /> Depth to water:. 6E <br /> Start purge: 3,21CC Sampling time: 35 <br /> Time Temp. E. C. pH Turbidity Volume <br /> 34 -L2___-Z57L- <br /> 3 45 1 G -7, l 7z/ z <br /> 3 y 4 2Z 3 <br /> 35 CIO i .) )/0 1+ <br /> Sample appearance: 1-1 — 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 /> • f <br /> Remarks: <br /> �y <br /> signature: <br />