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DOULOS ENVIRONMENTAL COMPANY <br /> SAA JNG INFORMATION SHEET <br /> Client: Ultramar Diamond Shamrock Sampling Date: <br /> 3 r2S r " <br /> Site:— Beacon #641 Project No. : 98-641-01 <br /> 1210 East Hammer Lane Well Designation: <br /> Stockton CA <br /> � YES time:�,� hours <br /> Is setup of traffic control ellbos'required. A YES Above TOC Below TOC <br /> Is there standing water in well box. If no, see remarks <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? N _ D <br /> Height of well casing riser (in inches) : 12„ EMCO 8« BK <br /> Well cover type: 8" UV 6" CNI Other <br /> 12" BK 12" DWP CNI-- Fair Poor <br /> General condition of wellheassembly: Excellent C <br /> 2" disposable bailer Submersible pump <br /> Purging Equipment: 211 pVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> "rP <br /> Sampled with: Disposable bailer: Teflon bailer:._ <br /> �r- <br /> Well Diameter: 2" 4 691 $" <br /> 47 2 . 61 gal/ft. <br /> 1 65. . <br /> Purge Vol. Multiplier: 0. 16 0 •s. <br /> t'a Measurement Re � ar a Measureme tCalculated purge <br /> Time: Time: ,� Actual purge: •Depth of well: S5-.05" Depth to wat�Ty <br /> Depth to water__-__M= �• f <br /> Start purge:_ �= 9 Sampling time: <br /> Time Temp. <br /> E.C. pH Turbidity volume <br /> to G "�- <br /> �; I f 214 7 • 3 D �`� <br /> 3 <br /> • IS rs'�. o �� 7.yG <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition <br /> ofrepla32 ced item <br /> 2" Locking Cap: Lock #3753 :,^_ 9/16 Bolt: <br /> 4" Locking Cap: Lock-Dolphin:��. <br /> Pinned Allenhead (DWP) : <br /> 6" Locking Cap: ,_ <br /> Remarks: <br /> Signature: <br />