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DOULOS ENVIRONMENTAL INC. SAMPLING INFORMATION SHEET <br /> Client Envyonesr ,Inc. Sampling Date. <br /> Site- California Tank Lines Project No <br /> 3105 S El Dorado Street Well Designation <br /> Stockton,CA <br /> Is setup of traffic-comt ml devices required? 60,1 S toile- hours <br /> Is there standing water m the well box? NO Above TOC Below TOC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked? NO If no,see remarks <br /> Height of well casing user(m inches)- <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Chnsty <br /> 121"Christy 8"M90 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent. Good�Ea�r Poor <br /> Purging Equipment• ' 2"disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4"PVC bailer Centrifugal.Pump <br /> Sampled with' Disposable bailer Teflon bailer Disposable Tubing _ <br /> Well Diameter 2" 4" 87• <br /> Purge Vol Multiplier 0.16, 065 147 2.61 gall <br /> Initial Measurement Recharge Measurement { <br /> Time. '` 'e Time. Calculated purge <br /> Depth of well: ;z- Depth to water- 3 -2 0 Actual purge: <br /> Depth to water t 4 <br /> Start purge ./ -0 0 Sampling time. <br /> Time Temperature E C pH Turbidi Volume <br /> Sample appearance* Lock. <br /> Equipment replaced. (check all that,apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lack, 7/32 Allenhead <br /> 4"Locking Cap Lock-Dolplun 9116 Bolt- <br /> 6"Locking Cap, Pinh6d Allcnhead(DWP) <br /> Remarks <br /> serQo <br /> -�ature. <br />