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DOULOS ENVIRONMENTAL, INC. SAMPLING INFQRMAT10N SHEE'1 <br /> Client: ltramar - Sampling Date; j( p <br />' Site: Beacon #3641 _ _ Project No ; <br /> 1210 E.Hanuner Lane 1400 Well Designation; _/'1 V.- — <br /> S tockton.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? NO If no, see remark$ <br /> Is well cap sealed and locked? NO If no, see remarkq <br /> Height of well casing riser(in inches): Q� <br /> Well cover type: 8"or 12"UV 12" $MCO 8"or 12"BK 8" Chrio.ty <br /> 12"Christy 8"M&D 12"M&D 12"DWP <br /> 12"CNIr 36" CNI 12"Pomeco Other: <br /> General condition of wellheQd assembly: Excellent Good Faire $oor <br /> Purging Lquipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer _ �Dodieated bailer. <br /> 4"PVC bailer CIntrifugal pump <br /> Sampled with: Disposable bailer Teflon bailer Dispose#ble Tubing_ <, <br /> Well Diameter; 2" 41) 67P <br /> Purge Vol. Multiplier: 0.16. 0,65 1.47 2,61 gal/ft. <br /> Initial Measurement Rechar a Measurement <br /> Time; es': Time: 0 . cl Calculat d purge: 17 <br /> Depth of well: Depth to water: S 0 . Actu41 purge: 15 <br /> Depth to water: 7 <br /> Start purge: 7 C� Sampling time: 7cl <br /> .. <br /> Time —L—Temperature E.C. H . I'urbidi Volume <br /> 7 - 53 62-• 4:5. , <br /> G g / S o G , 7 Z <br /> Sample appearance: Clell— Lock: <br /> Equipment replaced: (check all that apply) Note condition of repfac'ed item(s) <br /> 2"Locking Cap: Lock: 7/32 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin: 9416 Bolt: <br /> 6"Locking Cap: Pinned Allenhead (D"): <br /> Remarks; <br /> Signature: <br />