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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: <br /> Stockton CA <br /> Is setup of traffic control devices required? O 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 rennib <br /> Is well cap sealed and locked? NO If no.am remarks <br /> Height of well casing riser(in inches): So— <br /> Well cover type: 8"UV 12"UV 12"EMCO 8"BK <br /> 12" BK 12"DPW 12"CNI 36"CNi Other ZL <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 -Ceatrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> Well diameter.. 2" 4"_ 6" 8" <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 gam <br /> W ial Measuream Rmhne Measurement <br /> Time:_G13 D Time: Calculated purr: � °Z <br /> Depth of well:—C. Depth to water. Actual ptuge: <br /> Depth to water. 73.6 6 <br /> Stat purge: /oD Ll Sampling time: 1 Du- <br /> Time Temperature E C. pH Turbidity Volume <br /> l000 7.13 <br /> 16 <br /> r V1 7.1-6 <br /> 715 <br /> Samplc appearance: Lock: <br /> Equipment replaced. (Check all that apply) Note condition of replaced items <br /> 2" locking cap: Lock#3753: 7132 Allenhead. <br /> 4" locking cap: Lock-Dolphin: 9116 bort: <br /> 6" locking cap: Pinned Allenhead{DPµ'}: <br /> Remarks: <br /> Signature <br />