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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 3 - )_ eWrd,,7, <br /> iSite: R 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? 411P YES time: hours <br /> Is there standing water in well box? 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 �Mp If no, see remarks <br /> Height of well casing riser (in inches) : 'al <br /> Well cover type: 8" UV 12" UV12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent oZ1 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:--X bailer: <br /> Well Diameter: 2" 411 6" 811 <br /> Purge Vol. Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge .Measurement <br /> Kime: q- 9O Time: 11., 11 Calculated purge: `� 7 <br /> epth of well: . d2-y- � Depth to water: 70' 13 Actual purge: <br /> Depth to water: 6 !Z 5 <br /> Start purge: (o: �o . Sampling time: 11 IS <br /> Time Temp. E.C. pH Turbidity Volume <br /> 66 • $ q 1 L, t <br /> 0Ic5Lf G 9 J47 ti. 6 <br /> o. s 68. 0 8 �0 5f 3 <br /> ff:07 B �I� 4, 4 4 <br /> Sample appearance: Jr✓ Lock: r <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: i 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: --- <br />