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DOULOS ENVIRONMENTAL; INC, SAMPLING INFORMATION SHEET <br /> Client; Ultramar Sampling Date: 6 -- 1ta F-q c <br /> Site: Beacon 3641 Project No : <br /> I210 E.Hammer Lane1400 WeII Designation: _ NI tai r t' <br /> ..... <br /> ------------------- <br /> Stockton.Ca. <br /> Is setup of traffic control devices required? 0 YES time; hours <br /> Is there standing water in the well box? 5D YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remark: <br /> Is well cap sealed and locked? y NO If no, see remarks <br /> Heigh[of well casing riser(in inches); }' <br /> Well cover type: 8"or 12"UV 12"EMCO 8"or 12"BK 8" Chri$ty <br /> 12"Christy8"M&D� 12"M&D 12"DWP <br /> 12"CM 36" CNI 12"Pomeoo Other; <br /> Gonval condition of wellhead assembly; Excellent Qood t FafF�T� Poor <br /> Purging Equipment: 2"disposable bailerSubmersible pump <br /> 2" PVC bailer D6diaated bailer- <br /> 4"PVC bailer. _CInhifu,gal pump <br /> Sampled with: Disposable bailer Teflon bailer Disposable Tubin9--- <br /> Well <br /> ,Well Diameter: 2" 4" ,�^ 6" $„ <br /> Purge Vol. Multiplier: (TI 0.65 1.47 612 6I gaUft. <br /> Initial Measurement Rechar a Measurement <br /> Time; 6 -' 3 Time: F Calculated purge: 5 q <br /> Depth of well: • 6 Depth to water: .5' 0 , .6 Actual purge; <br /> Depth to water: 29 Ct O <br /> Start purge: O Sampling time; 9 i Time Temperature E.C. H . Turbidi_ Volume <br /> 6c7 <br /> 6e 2— <br /> : <br /> . j <br /> 65 . 1 02 0 <br /> Sample appearance; Lack; y <br /> Equipment replaced: (check all that apply) Note condition ofreplacd items) <br /> 2"Locking Cap: Lock: 7/32 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin: 9�I6 Bolt: <br /> 6"Locking Cap: Pinned Allcl head D <br /> Remarks: , <br /> Signature: <br />