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- "'.�+wvr.w.*yiww+s�rr..�+w..M.ta��yn�•�.-aWrvw��M.ei+.+—..w...r ......w-- ....ter. <br /> DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client Ultramar Sampling Date 12 'a G O 2— <br /> Site <br /> Site Beacon#3641 Project No - <br /> 12I0 E Hammer Lane 1400 Well Designation <br /> Stockton Ca <br /> Is setup of traffic control devices required9 YES time hours <br /> Is there standing water in the well box? N Y Above TOC Below TOC <br /> Is top of casing cut lever O If no,see remarks <br /> Is well cap sealed and Iocked? I NO E If no, see remarks <br /> Height of well casirig riser(in inches) <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Chnsty • 8"M&D 12"M&D 12"DWP <br /> 12"CM 36"CNI 12"Pomeco Other <br /> Ger•eral condition of wellhea assembly Excellent Good Fair Poor <br /> Purging Equipment 2" disposable bailer S-e- Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer—�'/� �- Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 81, <br /> Purge Vol Multiplier 016 065 1 47 2 61 gal/ft <br /> .Initial Measurement Recharge Measurement <br /> Time A,0. 0 1 Time Calculated purge 2 0- 2 <br /> Depth of well $'a Depth to water Actual purge <br /> Depth to water C/ . :56 <br /> Start purge _1 . Sampling time 3 <br /> Time Temperature E C pH Turbidity Volume <br /> (905- Wig' <br /> �3y2- 6o6 6.63 <br /> 1 3; qy /.,9-,pe G2zo 6 S = �� <br /> Sample appearance _ -- Lock ��_lji" <br /> r- <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 /> Signature =' ll <br />