Laserfiche WebLink
DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client Ultramar Sampling Date <br /> Site Beacon #3641 Project No <br /> 1210 E Hammer Lane1400 Well Designation ✓ <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 casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked? c-) <br /> NO If no,see remarks <br /> Height of well casing riser(m inches) <br /> Well cover 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"CN I —3J5"'J12"Pomeco Other <br /> General condition of wel ead assembly Excellent Good_Nt5 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 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time 6 2 Time 9 4 0 Calculated purge O , <br /> Wepth of well s ( Depth to water o / 2 Actual purge ® V1 <br /> Depth to waterg c' r '! <br /> Start purge 9 7 Sampling time <br /> Time Tem erature EC 2H Turbidity Volume <br /> L2 G a <br /> Sample appearance CXR Lock �..�.r,�� <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 /> 'oemarks <br /> Signature <br />