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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon 4 74 <br /> Project No. : 94-474--01 <br /> 3440-- E. Main Street Well Designation: MW- <br /> Stockton, CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? _ U YES Above TOC Below .TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NOIf no, see remarks <br /> Height of well casing risen (in inches) : Xt3 <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 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:--k Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8+1 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2. 61 gal/ft. <br /> AlUnitial Measurement Recharcre Measurement p <br /> ,Wrime: /D Z _ Time: 12-1 Lt Calculated purge: j2 <br /> Depth of well: e4F06 Depth to wa er: 1- Actual purge <br /> Depth to water: r <br /> _� J f <br /> Start purge: 11-J--L Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> 7,41 <br /> // <br /> Sample appearance: Lock: l <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: Bo A A/i17 <br /> Signature: <br />