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Ij1 <br /> DOULOS ENVIRONMENTAL COMPANY SAP SING INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: <br /> 3 -mss' - q � <br /> Site: Beacon A9641 Project No. : 98--641-01 <br /> 1210 East Hammer Lane Well Designation: [J r 3 <br /> Stockton CA <br /> hours <br /> Is setup of traffic control devices,required? YES time: <br /> TOC Below TOC <br /> Is there standing water in well box. NO � if no, see remarks <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap sealed and locked? N 4 <br /> Height of well casing riser (in inches) : 12" EMCO $" BK <br /> Well cover type: 8" UV 1201 UV 36" CNI� Other <br /> 12" BK 12" DWP_ &dq-fs <br /> NI- Fair Poor <br /> General condition of wellhsembly: Excellent �� <br /> 2" disposable osable bailer _.Submersible pump <br /> Purging Equipment: - 291 pVC bailer Dedicated bailer <br /> 41+ PVC bailer P Centrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> Well Diameter: 211 <br /> 4" 6"� 8n <br /> Purge Vol. Multiplier: 0. 16 p <br /> 0.65 1.47 2. 61 gal/ft. <br /> a Me su ement <br /> nRe5chtar a MeasurementCalculated purge: t ' <br /> i :— ,p Time: 0 Actual purge: <br /> Time <br /> Depth of well: s ' 0 7 Depth to water: <br /> Depth to water: <br /> `� ' <br /> Start purge: Sampling <br /> • <br /> Time Temp. <br /> E.C. pH Turbidity Volume <br /> '7 <br /> 712 3G7 � � o • s� <br /> 67 C2 <br /> 7:9S 4`9- 11g� 7• - `-( <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> Lock 13753 : 7/32 Allenhead:�� <br /> 2„ Locking Cap:_, _ Lock <br /> 9/16 Bolt:_______ <br /> 4 Lacking Cap: _ Pinned Allenhead (DWP) : <br /> 6" Locking Cap:.^. ._ <br /> Remarks: <br /> Signature: <br />