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DOULOS ENVIRONMENTAL INC. SAMPLING INFORMATION SHEET <br /> Client. Envixoneenn ,Inc Sampling Date, <br /> Site California Tank-Lines Project No. ' <br /> 3105 S El Dorado Street Well Designation- e <br /> Stockton, CA <br /> Is setup of traffic control devices required? YES tune hours _ <br /> Is there standing water m the well box? YFS Above TOC Below TOC <br /> Is top,of casing cut level? NO if no,see remarks <br /> Is well cap scaled-and locked? If no,see remarks <br /> Height of well rasing riser(nn inches)- <br /> Well cover We 8"or 12"UV 12"EMCO 8"or,12"BK 8"Christy <br /> IT,Christy 8,M&D 12"M&D 12"DWP <br /> 12"CNI 36"CVI 12"Pomeco other- Cyt <br /> General condition of wellhead asscmbly Excellent Good Fair` Poor <br /> Purging Equipment- 2"dispgsable bailer Submersible pump <br /> 2"PVC bailer' Dedicated°bailer <br /> W'PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer %e"', Teflon bawler Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> PurgeVol.Multiplier 16 065 147 2-61 gal/ft <br /> Initial Measurement Rechar a Measurement <br /> Time :(!,Z Time �3 5- Calculated purge <br /> Depth of well Depth to water. .1.7, Actual purge. . <br /> Depth to water: <br /> Start purge., tx� Sampling time. <br /> TimeTemperature E C H Turbidi `Volume <br /> . , 1. 2' r <br /> M� <br /> ei <br /> f <br /> { <br /> Sample appearance. .`� Lock. f <br /> Equipment replaced- (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock- 7132 AlIenhead: <br /> 4"Locking Cap- Lock.-Dolphin. 9/16 Bolt. <br /> b"Loclang Cap. Pinned Allezi$i ad(DWT): <br /> I <br /> Remarks. _ <br /> SignatAP <br />