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DOULOS ENVIRONMENTAL, INC SAMPLING INFORMATION SHEET <br /> Client Ultramar, Inc Sampling Date G —�1? -0 <br /> Site Beaconfi ?) �A Project No 94-641-01 <br /> 1210 E Hammer Lane Well Designation <br /> Stockton CA <br /> 1s setup of traffic control devices required9 YES time hours <br /> Is there standing water in the well box9 YES Above TOC Below TOC <br /> Is top of casing cut level? NO eM If no, see remarks <br /> Is well cap sealed and locked? NOTff�) If no,see remarks <br /> Height of well casing riser(in inches) 0— <br /> We I I <br /> Well co%er type 8" or 12"UV 12" EMCO 8"or 12" BK 8"Chnsty <br /> 12 Christy 8"M&D 12"M&D 12" DWP <br /> 12 CNINI 12"Pomeco Other <br /> General condition of w d assembly Excellent Good_K, 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" /X- 4" 6" 8" <br /> Purge Vol Multiplier 016 065 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time . 3 Time q : L( 9_ Calculated purge - i <br /> epth of well SS'- 3 Depth to water _ /Q Actual purge <br /> epth to «ater y . 96 <br /> Start purge q - L(Q Sampling time 4 <br /> Time Temperature E C H Turbidity____ Volume <br /> � 1 70 , q / 9 ? , 2I ' <br /> G L12 ' O ' / 7- / Z <br /> 91H4 7/ 1d � l0 7 - I5 <br /> t 45 / o6 7 / 3 <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 /> marks <br /> Signature <br />