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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 11-- C`96 <br /> Site: Beacon #474 Project No. : 94-474-01 <br /> 3440 E. Main Street Well Designation: MW- <br /> Stockton, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? 9 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" UV zX. 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposal bailer:_ Teflon bailer: <br /> Well Diameter: 2" 4" 611 $11 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement � <br /> Time: o Time: /I Calculated purge: , <br /> Depth of well. !7 Depth to water: 3 Actual purge: s1.7 /1_ <br /> Depth to water: S 7 <br /> Start purge: /!:, t Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 16 q' 70 <br /> Sample appearance-. <br /> Lock: ?fir <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 /> Siqnature: <br />