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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon 9474 Project No. : 94-474-0I <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? tQ 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 ES If no, see remarks <br /> Height of well casing riser (in inches) : -i <br /> Well Well cover type: 8" UV 12" UV L 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI , _ Other <br /> General condition of wellhead assembly: Excellent �o� 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 <br /> ailer:Well Diameter: 2" 4 r' < 6" 811 <br /> Purge Vol. Multiplier: 0 . 16 0.65 1. 47 2. 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: /033 Time:_�J 2— _ Calculated purge: SG,I <br /> Depth of well: S Depth to water: G 7 Actual purge: S6.1 il <br /> Depth to water: r,-7..53 <br /> Start purge: 44 3, Sampling time:_/z fa <br /> Time Temp. E.C. pH Turbidity Volume <br /> /I <br /> y? 7,Z t{ 1 <br /> OL 6 5r.1 7 3 <br /> lzoq 7 Z=L 72 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) - Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: j <br /> r- <br /> Signature: <br />