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DOULOS ENVIRONMENTAL INC. SAMPLING INFORMATION SHEET <br /> Client Environeering,Inc Sampling Date 0 <br /> 38 of 61 <br /> Site California Tank Lines Project No <br /> 3105 S El Dorado Street Well Designation <br /> Stockton,CA <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well box? Above TOC Below TOC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked? f� NO If no,see remarks <br /> Height of well casing riser(in inches) < <br /> wolf cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Chesty <br /> 12"Chnsty 8"M&D 12"M&D 12"DWP <br /> 12"CM 3 6"CIVI 12"Pomeco Other6wo' 4•- <br /> General condition of wellhead assembly. Excellent Goodj< Fan' Poor <br /> Purging Equipment 2"disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> bailer Centrifugal pump <br /> Sampled with' Disposable bailer �'�,.� Teflon bailer Disposable Tubmg <br /> Well Diameter T' 411 6" all <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time oeOl Y-3 Time- 2 3 Calculated purge- <br /> Depth of well Depth to water- S G.3 Actual purge <br /> Depth to water n t/-Z <br /> Start purge Z - Z Sampling time 3 <br /> Time Tem erature E C. PH Turbid! Volume <br /> 'z : z 7 .z <br /> Sample appearance. Gr,Dwr.�•!/_ Lock. <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7132 Allenhead <br /> 4"Locking Cap Lock-Dolphin 9/16 Bolt <br /> 6"Locking Cap. Pinned Allenhead(DWP). <br /> Remarks. $�`'� '� <br /> Signature: -- <br />