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DOOLOS ENVIRONMENTA COMPANY SA� ING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: :-Il-q� <br /> Site: Beacon 513 Project No. : 94-513-01 ; <br /> A <br /> 401 W. Kettleman Ln. Well Designation: MW-3 <br /> Lodi CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? 9 YJS Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO E I€ no, see remarks <br /> Height of well casing riser (in inches) <br /> Well cover type: 8" UV 12" W �_ 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 Centrifugal pump <br /> Sampled with: Disposal bailer: / Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> k <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> r Initial Measurement Recharge Measurement <br /> Time:__ I115 Time:_ IL Calculated purge: 37 <br /> Depth of well: 71.60 Depth to water. G�-,� f Actual purge: L- ,,1711 <br /> Depth to water: C,,;1-7 <br /> Start purge: ILIL Sampling time: 50 <br /> Time Temp. E.C. pH Turbidity Volume <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 /> 1 <br />