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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client Ultramar Inc Sampling Date 6-1�—a� <br /> . Site _BeaconL4T 3b-_l Project No 94-641-01 <br /> 1210E Hammer Lane Well Designation <br /> Stockton. CA _ <br /> Is setup of traffic control devices required? YES time . . hours <br /> Is there standing water to the well box) YES Above'FOC Below TOC <br /> Is top of casing cut level? If no, see remarks <br /> Is cell cap sealed and locked9 NO If no,see remarks <br /> Height of well casing riser(in inches) 3 <br /> Well co%er type 8" or 12"IN 12"EMCO 8"or 12"BK 8"Christy <br /> 12 ' Christy 8" M&D 12"M&D 12"DWP <br /> 12 ' CNI 36" CNI 12"Pomeco Other A/? <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 Tubing <br /> Well Diameter 2"�_ 4" 6" 8" <br /> Purge Vol Multiplier 0 16 065 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time S ' Time _ 7' 2 Calculated purge - _ <br /> Depth of well S'- O Depth to water `�3 C7 Actual purge _ � <br /> :7 � <br /> Depth to water Z <br /> Start purge 7 j Sampling time 7 <br /> Time Tem erature EC pH Turbidi Volume <br /> ( 9 9 7 o ? • 3 <br /> 2.0 - 1 f6 6 7 "Z- <br /> Sample <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 (DWT) <br /> �emarks <br /> Signature <br />