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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: /D-/4/-9U <br /> Site: Beacon 513 Project No. : 94-513-01 <br /> 401 W. Kettleman Ln. Well Designation: MW- <br /> Lodi, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? � YES 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) : <br /> Well cover type: 8" W 12" uv - 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer XCentrifugal pump <br /> Sampled with: Disposal bailer:_ Teflon bailer: <br /> Well Diameter: 2" 411�X 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: 450 — Time:-60g Calculated purge: 9 <br /> Z <br /> `�- Depth of well: 7q.J.a` Depth to water: - Actual g <br /> Depth to water: G7,06 <br /> purge: 3�. 6 h <br /> Start purge: 513 Sampling time: 61D <br /> Time Temp. E.C. pH Turbidity Volume <br /> s It 70.1 7 7_ pfd 1 <br /> 5Z3 73,-6 761 7, 42 Z <br /> 3.Lf 74 1) 75 / 3 <br /> 3 5 1 742- 737 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753: 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: s _A , <br />