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No <br /> DOULOS ENVIRONMENTAL, INC, SAMPLING INFORMATION SHEET <br /> Client Ultramar Sampling Date <br /> iSite Beacon #3641 Project No <br /> 1210 E Hammer Lane 1400 Well Designation tJ <br /> Stockton,Ca _ <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casLng cut levcl9 NO If no, see remarks <br /> Is well cap sealed and locked? + 16 r 6 NO If no, see remarks <br /> Height of well casing user(in inches) <br /> Well cover type 8"or 12"UV 12" EMCO 8"or 12"BK 8" Chrisry <br /> 12"Chnsry 8" M&D 12"M&D 12"DWP <br /> 7 k-2+"+���Nl 36"CNI 12"Porneco Other <br /> Geff21 condinon of wellhead assembly Excellent Good-->c— 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 Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 0 16 065 1 47 2 61 gal/ft <br /> Initial Measurement Rechare Measurement <br /> Time gr Time ) � Calculated purge - <br /> Depth of well q Depth to water ye� APO Actual purge -O <br /> Depth to water <br /> Start purge 1 0 6 Sampling time l 3 <br /> Time Temperature E C pH Turbidity Volume <br /> - D � 01 <br /> p . . LfS 2 . � <br /> D <br /> 1 '- 01 0 .5 <br /> I -.1.0 <br /> Sample appearance ��`� [.vL� 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 /> Signature <br />