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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: — C —0 -! <br /> Site: Beacon#3641 Project No.: <br /> :1M W !_571210 E.Hammer Lane1400 Well Designation: <br /> Stockton.Ca. <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in the well box? Y Above TOC Below TOC <br /> Is top of casing cut level? NO if no, see remarks <br /> Is well cap sealed and locked? /� NO If no, see remarks <br /> Height of well casing riser(in inches): f &- <br /> Well cover type: 8"or 12"UV 12"EMCO 8"or 12"BK 8" Christy <br /> 12"ChTisty 8"M&D 12"M&D 12"DWP <br /> CNI 36"CNI 12"Pomeco Other: <br /> General condition 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 Tubin <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: / Time: 10! 01 Calculated purge: 2, <br /> Depth of well: 73 - O/ Depth to water: 45 Actual purge: <br /> Depth to water: <br /> Start purge: =y3 Sampling time: <br /> Time Tem erature E.C. p H Turbidi!y Volume <br /> 7 ; <br /> 9110 2 • 32S7 <br /> 3 <br /> 73 :2 3oS , 7• oG Y <br /> Sample appearance: Lock: �-`. <br /> Equipment replaced: (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap: Lock: 7132 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin: 9116 Bolt: <br /> 6"Locking Cap: Pinned Allenhead (DWP): <br /> Remarks: <br /> - S <br /> Signature; <br />