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DOULOB ENVIRONMENTAL OMPANY SAI ING INFORMATION SHEET <br /> i Client: Ultramar Sampling Date: - 1 5 <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? V YES Above TOC Below TOC <br /> Is top of casing cut level? NO J�D If no, see remarks <br /> Is well cap sealed and locked? NO E 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" DWP 12" CNI 36" CNI ather <br /> General condition of wellhead assembly: Excellent c od) 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: Disposal bailer Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: u1� Time: 11 j Calculated purge: U.3 <br /> Depth of well: 71, L1 Depth to water: Actual purge: 4A,3 <br /> Depth to water:_ 6.7- 46 <br /> Start purge: ff3l? Sampling time: 1155 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1 1 3 5 70 g, 4 2- <br /> 70V <br /> 70y L.+ r 7-10 3 <br /> 1150 7o 1- 4 17 7 1 q <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: <br />