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y'. <br /> DOULOS ENVERONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: r 'j`1- 7-5 <br /> Site: Beacon#513 Project No.: 94-513.01 <br /> 401 W. Kettleman Lane Well Designation: MW- <br /> Lodi,CA <br /> Is setup of traffic control devices required? (Iq�) �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 Y If no,see remarks <br /> Height of well casing riser(in inches): <br /> Well cover type: 8"UV 12" UV 12"EMCO 8"BK <br /> 12"BK 12"DPW 12" CNI 36" CNI Other <br />{ General condition of wellhead assembly: ExcellentGoo Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 3" PVC bailer Dedicated bailer <br /> 4" PVC bailer _Centrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> Well diameter: 2" 4" 6" 8" <br /> Purge Vol.Multiplier: 0.16 0.65 1.47 2.61 gallft <br /> Initial Measurement Recharge Measurement <br /> Time: 6 D Time: 65-q Calculated purger <br /> Depth of well: 741 b Depth to water: Actual purge: <br /> Depth to water:j <br /> Start purge : 6 Lf•Q Sampling time:706 <br /> Time Temperature E. C. pH Turbidity Volume <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced items <br /> 2" locking cap: Lock#3753: 7132 Allenhead: <br /> 4" locking cap: Lock-Dolphin: 9116 bolt: <br /> 6" locking cap: Pinned Allenhead(DPW): <br /> Remarks: <br /> Signature: <br />