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DOULOS ENVIRONMENTAL.COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: . <br /> Site: Beacon#474 Project No.: 94-474-01 II <br /> 3440 E. Main Street Well Designation: MW- I <br /> Stockton.CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? J& YES Above TOC Below TOC <br /> Is top of casing cut level? NO IM If no,see remarks <br /> Is well cap sealed and locked? NO If no,we remarks <br /> Height of well casing riser(in incites): <br /> Well cover type: 8"UV 12"W 12"EMCO 8"BK <br /> 12" BK 12"DPW 12" CNI 36"CNI Other&Y'=V"._ <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> Purging Equipment: 2"disposable bailer Submersible pump <br /> 3"PVC bailer Dedicated bailer <br /> 4"PVC bailer Centrffugal pump <br /> Sampled with: Disposable bailer: k Teflon bailer: <br /> Well diameter. 2" 4" 6" $" <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 ga11R <br /> Initial Measurement Rech+ p Measurement <br /> Time: 117 Tines J� Calculated purge: 3�. <br /> Depth of well: 1• S Depth to water.�4,C_J,_ Actual purge: 3J 6 -,1- <br /> Depth <br /> Depth to water: 74 t- k <br /> Start purge: Sampling time: /b b n <br /> Time Temperature E.C. pH Turbidity vChmw <br /> 17 <br /> 0 70 a t — 3 <br /> ------- <br /> Sample Appearance : ��_ _ Lock: <br /> E.quipmcni replaced: (Check all that apply) Note condition of replaced items <br /> 2" locking cap: Lock 03753: 7132 Allenhead: <br /> 4" locking cap: Lock-Dolphin: 9116 bolt: <br /> 6" locking cap: Pinned Allenhead(DPW): <br /> Remarks: <br /> Signature: <br />