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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon #474 Project No. : 94-474-01 <br /> 3440--E. Main Street Well Designation: MW- 3 <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? � YES Above TOC Below TOC <br /> Is top of casing cut level? NO cX2:P if no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser ( in inches) : _ �30 _. <br /> Well cover type: 8" UV12" UVB 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent C � 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" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Rechar a Measurement <br /> Time: Time: O Calculated purge: y3. 91� <br /> .Depth of. well: r� � lq Depth to water: 7�' 3 Actual purge: X13 7_67 <br /> Depth to water:_ 6 5;/1_3�. _ <br /> Start purge: I ' S 1 Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> �{ <br /> 69' -( 766 L k <br /> �ql 76 30 <br /> 1,6 <br /> 3 <br /> r S <br /> Sample appearance: Lock: JQ <br /> Equipment replaced: (Check all that apply) Note conditio 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 /> f <br /> signature: <br />