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r <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client. Ultramar Diamond Shamrock Sampling Date* 3 – 1 <br /> i <br /> Site - Beacon x`641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: <br /> Stockton CA <br /> Is setup of traffic control devices required' YES time• hours <br /> Is there standing water in well box's Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : 71---/ <br /> Well cover type : 8" UV12" UV12" EMCO $" BK <br /> 12" BK 12" DWPKd%f <br /> NI V 36" CNI Other <br /> General condition of ellh sembly: ExcellentFair Poor <br /> w <br /> Purging Equipment: 211 disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 41' PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:—?S-" Teflon bailer: <br /> Well Diameter: 2"_X_ 4" 6" 811 <br /> Purge Vol . Multiplier: 0 . 16 0. 65 1 . 47 2 61 gal/ft. <br /> itial Measurement Rechar a Measurement S4 <br /> Time: O Time: = a Calculated purge <br /> Depth of, well .• S � 2 Depth to water: 3 • � Actual purge : <br /> Depth to water• <br /> Start purge: q Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> � �S S 9 � ! 0 3 3 7 •�� ____�__ � <br /> Sample appearance: C�� � Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/1.6 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />