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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Dats;; —f G <br /> Site: Beacon #36415 <br /> Project No : <br /> I210 EAammer Lanel400 Well Designation: /1*1 U — <' <br /> Stockton,Ca.. <br /> Is sctup of traffic control devices required? le9YES time: �hours <br /> Is there standing water in the well box? 'YES Above TOC i Below TOC <br /> Is top of casing out level? Qow If no, see remarkq <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"UV 12"EMCO 8"or 12"BK 8" Christy <br /> 12"Christy8"M&ID 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeoo Other: <br /> Goncral condition of wellhead assembly: Excellent Cood _ Fair $oor <br /> Purging Equipment: 2" disposable bailer _ >I--- �SArnersible pump <br /> 2" PVC bailer Do'dicated bailer <br /> 4"PVC bailer COntrifugal pump <br /> Sampled with: Disposable bailer_ Teflon bailer Dispos4ble Tubing <br /> Well Diameter: 2"__)_1_ 41J 69► $„ <br /> Purge Vol. Multiplier; 0.16. 0.65 1.47 2,61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time; 6','/0Time: 7' o Calculated purge; 3 18 <br /> Depth of well: 6 -7 Depth to water: Actu4l purge; <br /> Depth to water: ! •/ <br /> Start purge: 7 ' �b Sampling time: 7 • �/ r <br /> Time Temperature E.C. H . Turbidi Volume <br /> c9S , � � ; <br /> °! 2 <br /> e; 2d , <br /> L <br /> Sample appearance: w`- Lock: N <br /> Equipment replaced: (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap: Lock: 7/32 Aller head: <br /> 4"Locking Cap: Lock-Dolphin: 9 ,1613olt: <br /> 6"Locking Cap: Pinned Allenhead <br /> (DWPi): <br /> Remarks: <br /> Signature: <br />