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SAI: ,ING INFORMATION SHEET <br /> DOUL08 ENVIRONMENTAL COMPANY <br /> Client: Ultramar Diamond Shamrock Sampling Date:., <br /> 3 -25 _ 12 <br /> Site; Beacon #641 <br /> Project No- :__99-641-0 <br /> 1,210 East Hammer Lane Well Designation: <br /> Stockton CA <br /> � <br /> hours <br /> Is setup of traff 1c control devicesrequired. YES time:YES Above TOC Below TOC <br /> Is there standing water in well box'. ® If no, see remarks <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap sealed and locked. NO O <br /> Height of well casing riser (in inches) :12" UV12" EMCO• 8„ BK� <br /> Well. cover type• 8,, W--- � 36” CNI Other <br /> " <br /> 12" BK 12DWP NI- <- <br /> Fair Poor <br /> General condition of wellhead assembly : Excellent <br /> 2" disposable bailer �L Submersible pump <br /> Purging Equipment: _ 211 PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: � P Teflon bailer: <br /> 411_ 6„ 8 t� <br /> Well Diameter: 2"_ <br /> 0,65 1.47 2 . 61 gal/ft. <br /> Purge Vol. Multiplier: 0. 16 echa a Measureme t <br /> it a Measureme t Calculated pttrge:�� <br /> Time: Time: �f 2 •/ Actual purge: <br /> Depth of •well: �s' �� Depth to water: <br /> Depth to water: <br /> : <br /> 7 ;O g sampling time: <br /> Start purge <br /> E.C. <br /> pH Turbidity Volume <br /> Time Temp. <br /> _LLJa <br /> rg Le 4f ZP <br /> 01 _2. / 3 ---- -- <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) <br /> Note cond X i An <br /> replaced <br /> 2" Locking Cap: Lock ,�3753 :�� 9/16 Bolt: <br /> 4" Locking Cap: ^�_ Lock-Dolphin: �_Pinned Allenhead (DWP) :�� <br /> 6" Locking Cap:_ _. <br /> Remarks: <br /> Signature: <br />