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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar sampling Date: <br /> Site: Beacon t474 Project NO. : 94--474-01 <br /> 3440 E. Main Street Well Designation: MW- <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 ES If no, see remarks <br /> Is well cap sealed and locked? NO EE If no, see remarks <br /> Height of well casing riser (in inches) : _`l _ <br /> Well cover type: 8" UV 12 " W 12" EMCO _ 811 BK <br /> 12 " BK .12" DWP 1.2" CNI 36" CNIther /-z-':d <br /> General condition of wellhead assembly: Excellent ood Fair Poore <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:_ Teflon bailer: <br /> Well Diameter: 2" 4" � 6" 811 <br /> Purge Vol . Multiplier: 0 . 1.6 0 . 65 1 . 47 2 . 61 gal/ft. <br /> Initial Measurement RecharcTe Measurement <br /> Time: p) Time: 91.'1 Calculated purge: 3P,5 <br /> Depth of well : !47 Depth to water: ?3.6/5 Actual purger <br /> Depth to water: <br /> Start purge: / Sampling time: -36 <br /> [Time Temp. E.C. pH Turbidity Volume <br /> r'11 7r.S loci/ <br /> 79T <br /> 1006 73 7 <br /> R, Z 71, 1- <br /> Sample appearance: r Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/1.6 Boit. <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> signature: -U, <br />