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DOULOS ENVIRONNEWAL COh%mANY SAMPLIiW INFORMATION SHEET <br /> Client: Ultramar Sampling Date; <br /> Site: Be con 513 Project No. :-94-513-01 . <br /> 401 W. Kettleman Ln. Well Designation:- MW- 1 <br /> Lodi CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? O 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) : I <br /> Well cover type: 8" UV 12" UV_ 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent t"o� Fair Poor <br /> Purging Equipment: 2" disposable bailer submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailerCentrifugal pump <br /> ,I 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 /> Tnitial Measurement Recharge Measurement <br /> me: X108 Time: 43K Calculated purge:�y� <br /> 11�pth of well: Depth to water: :�. 5 Actual purge: CcLi . <br /> Depth to water: 64.52, <br /> Start purge: q40 Sampling time:_14 f <br /> Time Temp. E.C. pH Turbidity Volume <br /> 51" 6 5 717 1 <br /> � q. 66i� 7.3 4 Z <br /> 5614 7-30 <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: L4ZAI-A�, <br />