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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client:. Ultramar Sampling Date: <br /> Site: Beacon#3641 Project No.: <br /> f 1210 E.Hamme=Lane 1400 Well Designation: I W Z <br /> Stockton.Ca. <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut level? If no,see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser(in inches): <br /> Well cover type: 8"or 12"W 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy '8"M&D 12"M&D 12"DWP <br /> 12"CNI36"CM 12"Pomeco Other: <br /> General can tion of wellhead assembly: Excellent Good_ Fair 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" �K— 4" 6" 8" <br /> Purge Vol.Multiplier: 0.16 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement Recharize Measurement <br /> Time: 10= 23 -Time: it 30 Calculated purge: S • Z <br /> Depth of well: 71. 53 Depth to water: y q • r 3 Actual purge: / <br /> Depth to water: 4 7 -7 2 <br /> Start purge: 11 W Sampling time: <br /> Time Temperature E.C. pH Turbidity Volume <br /> r/ -2 t` 3 / las' 6. 70 2 <br /> [� : z� �2 • 1� � o � � x•62- 3 <br /> G2 •S /o rd G 6 <br /> Sample appearance: Lock: <br /> Equipment replaced: (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap: Lock: 7/32 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6"Locking Cap. Pinned Allenhead(DWT): <br /> Remarks: <br /> Signature: <br />