Laserfiche WebLink
DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client Ultramar Sampling Date <br /> • Site Beacon#3641 Protect No <br /> 1210 E Hammer Lane1400 Well Designation M �✓� <br /> Stockton Ca <br /> Is setup of traffic control devices required YES tune hours <br /> Is there standing water in the well boxy Above TOC Below TOC <br /> Is top of casing cut level9 NO Co If no, see remarks <br /> Is well cap sealed and Iocked9l z NO If no, see remarks <br /> Height of well casing riser(un inches) <br /> Well cover type 8"or 12"UV 12" EMCO 8"or 12"BK 8"Chnsry <br /> 12" Chnsry 8"M&D 12"M&D 12"UWP <br /> I2"CNI 36"CNI I2"Pomeco Other <br /> General condinon of wellhead assembly Excellent Good Fair Poor <br /> Purging Equipment 2" disposable bailer X Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> Sampled with Disposable bailer4"PVC bailer Centrifugal pump <br /> Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4". X 6" 8g7 <br /> Purge Vol Multiplier 0 16 0 65 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time /O :2 Z- Time Calculated purge <br /> Depth of well 6 Depth to water Actual purge c <br /> Depth to water e-1 <br /> 4S <br /> Start purge 2: 5Z Sampling time 2:5P <br /> rZ <br /> Temperature E C H TurbidityVolume <br /> /a %'5 - c/ <br /> l9 S s � 06 9 <br /> z <br /> 5G i93 � � 2 �. g � y <br /> Sample appearance Lock j 1t414/ <br /> Equipment replaced (check all that apply) "yNote condition of replaced item(s) <br /> 2" Locking Cap Lock 7/32 Allenhead <br /> 4" Locking Cap Lock-Dolphin .' 9/16 Bolt <br /> 6" Locking Cap Pinned Allenhead (DWP) <br /> *Remarks <br /> Signature <br />