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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client Ultramar Inc Sampling Date <br /> • Site Beacon-641 h 1 Project No 94-641-01 <br /> 1210 E Hammer Lane Well Designation /,-I v,-r 5 <br /> Stockton CA <br /> Is setup of traffic control devices required' YES time hours <br /> Is there standing water in the well boxy emp YES Above TOC Below TOC <br /> Is top of casing cut leveh NO If no, see remarks <br /> Is well cap sealed and locked? 2 NO If no,see remarks <br /> Height of well casing riser(in Inches) fi <br /> Well coyer type 8" or 12"UV 12" EMCO 8"or 12"BK 8"Christy <br /> 12 Christy 8' M&D 12"M&D 12"DWP <br /> 12" CNI .1�I12" Polneco Other <br /> as <br /> General condition of wellhhd sembly Excellent Good Fair Poor <br /> Purging Equipment 2" disposable bailer _ ^C Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with Disposable hailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" X 6" 8" <br /> Purge Vol Multiplier 0 16 065 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time S = S Time ,9 ' ? 6 Calculated purge -79 <br /> Wepth of well 7 3 0 7 Depth to water • 7 O Actual purge <br /> epth to water 1-15 3( <br /> Start purge -'�? ' Sampling time " 3 <br /> Time Tem eraWre E C pH Turbidity Volume <br /> g � 3 6 9 6.so 1 <br /> 05'8 <br /> . 3o Gg rr I `1 O <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note 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 /> �emarks <br /> Signature <br />