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Ji <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 5 <br /> Site: Beacon 1419 Project No. : 94-419-01 <br /> Well Designation: MW-,��, <br /> Stockton, CA <br /> Is setup of traff is control devices required? 0 YES time: hours <br /> Is there standing water in well box? O 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" UV 12" OV 12" EMCO_,-C _ 8" BK_ <br /> 12" BK 12" DWP 12" CNI 36" CNIther <br /> General condition of wellhead assembly: Excellent o Fair 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: 2" 40 )( 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement Recharge Measuremg= <br /> �~ Time: !IR __.. Time: ►L'M Calculated purge: <br /> Depth of well: -i3 Depth to water: 6k 73 Actual purge: 52 y 4 <br /> Depth to water: KLo EJ <br /> Start purge:/1 I - Sampling time: / 0 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 011 730 ► <br /> 13 7 ZA l I P] 711. <br /> 142- 70.3 ' au3 71y <br /> 1406 20S 130 71 <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 />