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DOUL08 ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client* Ultramar Diamond Shamrock Sampling Date : <br /> Site , Beacon 0641 Project No . : 98-641-01 <br /> 1210 East Hammer Lane Well Designation, (/ W <br /> Stockton CA <br /> Is setup of traffic control devices required^7 YES time • hours <br /> Is there standing water in well box' Y S Above TOC Below TOC <br /> Is top of casing cut level'7 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) : -f--Je6 __.. <br /> Well cover type : 8" UV12" UV12" EMCO 8" BK <br /> 12" BK 12" DWP CNI_,,A, 36" CNI then <br /> General condition of wellhead Xsembly: Excellent el5oFair 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: <br /> Well Diameter: 211 <br /> -4 4" 6" 8" <br /> Purge vol. Multiplier: 0 . 16 0.65 1. 47 2 . 61 gal/ft . <br /> Initial Measurement Recharge Measurement -� <br /> Time : , 7 - � 3 _ Time: Calculated purge <br /> Depth of well : �y �S Depth to water: 7 -> O G Actual purge <br /> Depth to water: Q1 <br /> Start purge: zO - / Sampling time: � - <br /> Time Temp. E. C. pH Turbidity volume <br /> 7 ( 7. <br /> 2 ---- -� <br /> I Lo <br /> Sample appearance: 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: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />