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_DOULOS ENVIRONMENTAL.INC. SAMPLING INFORMATION SHEET <br /> Client EnvironeeriM Inc, Sampling Date. ` ` <br /> Site Cahforrua Tank Lines Project No . <br /> 3145 S El,Dorado Street Well Designation <br /> Stockton,CA <br /> Is setup of traffic control devices requ=ed9 YEStmae- hours <br /> Is there stau*g water m the wal!b6x9 N4 Above TOC Below TOC <br /> 1s top of casing cut levels NQ If no,see remarks <br /> Is well cap scaled aad`locktdl r NO If no,See remarks <br /> Height of well casing nser(m mches)- <br /> Well cover type 8"or 12"W 12"EMCO i 8"or 12"BK 8"Chnsty <br /> 12"Chnsty 8"M&D 12"NW) 12"DWP <br /> 12"CNI 36"CNI 1T'P�on=q i other .,_ C,t <br /> General condition of wellhead assembly ExceHeat k Good:,V Fair Poor <br /> 41 <br /> Purging Equipment- 2"disposable bmler Submersible pump <br /> 2"PVC°bailer Dedicated bailer <br /> 4"PX C bad,er Centrifugal pump <br /> Sampled with- Disposable batlei Teflon bailer Disposable Tubing_ <br /> Well Diameter T' <br /> Purge Vol Multiplier 0.16 0.65 147 2 61 gal/ft <br /> Initial 1yleasurenient Recharge Measurement <br /> Time = Tune a`° ` _ Calculated purge <br /> Depth of well: Depth to water: 3 5,. Q Actual purge- <br /> Depth to,water ,2 <br /> Start purge •3 Sarnpluig,teme �t <br /> Time Tem erature E C pH Turbidity, Volume <br /> a3 1 , go,f <br /> m <br /> Sample appearance �' ��1~' 1 4,, c'dkw Lock, <br /> Equipment replaced-, (check all that apply) Note,cendrtion of replaced item(s) <br /> 2",Locking Cap Lock 7132 Allenhead <br /> 4"Locking Cap ,Hock Dolphin - 9116 Bolt: <br /> 6"Locking Cap. Pinned Allenhead(DWP) <br /> Remarks to vyaLcy- ?'Ov `z e <br /> i <br /> � S�gnatur�e�° - <br />