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DOULOS ENVIRONMENTAL, INC, SAMPLING INFQRMATION SHEET <br /> Client: Ultramar _ Sampling Dato: <br /> Site: Beacon #3641 <br /> Project No,: <br /> ff <br /> 1210 E.Hamrner Lane 14 0 Well Designation; <br /> Stockton.Ca. <br /> Is setup of traffic control devices required?' YES time:—�.�_,hours <br /> Is therc standing water in the well box? 1Q YES Above TOC Below TOC <br /> Is top of casing out level? NQ If no, see remark4 <br /> Is well cap sealcd and locked? NO If]I sec remark <br /> Height of well casing riser(in inches). <br /> Well cover type; 8"or 12"UV 12"BMCO 8" or 12"SK 8Chrig.ty <br /> 12" luisty 8"M&D 12"M&D 12"MVP <br /> 'CM — 36" CNI 12"Pomeco Other: <br /> Denprol condition pf.wellhead assembly. Excellent Good Fair�• :_ Poor_ <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2 PVC bailer. Dddicated bailer, <br /> _ _4"PVC bailer Centrifugal pump <br /> Sampled'with: Disposable bailer- Z` Teflon bailer Disposable Tubing. <br /> Well Diameter: 2" X _ 411 6» 8;, <br /> Purge Vol. Multiplier: 0,16. 0,65 1.47 2,61 gal/ft, <br /> Initial Measurement Recharge,Measurement <br /> Time; <br /> y - 3 Time: 2 ' 3 s Calculatq_d purge: <br /> Depth of well: 6 1{• 6 X— Depth to water: -J13 Actu4I purge: <br /> Depth to water: L/ O <br /> Start purge: 1 °l - Q S <br /> Sampling time; <br /> Time Tem erature E.C. pH . Turbidi Volume <br /> f2 ' oG 70 - 6-71 <br /> 1 07 <br /> 12 ' 3 - � p ' <br /> ' Y <br /> Sample appearance: Lock: D � <br /> Equipment replaced: (oheck all that apply) Note condition of replaced items) <br /> 2"Locking Cap: Lock: 7/32 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin. 9 ,16 Bolt: <br /> 6"Locking-Cap: Pinned Allenhead <br /> Remarks: <br /> Signature: <br />