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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date:_ 3 .0 <br /> Site: Beacon #474 Project No. : 94-474-01 <br /> ] <br /> 344E._ Main Street_ Well Designation:_ MW_ <br /> Stockton, CA <br /> Is setup of traffic control devices required? (0time: h urs <br /> Is there standing water in well box? NOS Above TOC low C <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? No E If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV--&_ 1211 EMCO 8" BK <br /> 1211 BK 12" DWP l2" CNI 36" CNI ther <br /> General condition of wellhead assembly: Excellent ood Fair Poor <br /> i <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer - -',C Centrifugal pump <br /> I <br /> Sampled with: Disposal bailer:_ Teflon bailer: <br /> Well Diameter: 2" 411 611 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement gechgrge Measurement <br /> Time: l Time: q)_J Calculated purge; 37414J <br /> Depth of well: 94,11 __ Depth to water: 76, b n Actual purge: 3 7 <br /> Depth to water: U - <br /> Start purge: (CS 6 . Sampling time: 42_3 <br /> Time Temp. E. C. pH Turbidity Volume <br /> 1b 6 J, 4' Sar ?6 y -- 3 <br /> 6 5 3 76 <br /> ----------- <br /> Sample <br /> -------rSample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 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 /> Signature: <br /> .-e!e'. .'"•A.:.., .:�rM1+ . :F a c rYp.+. w� yyQ, ; t►i'i:i i;.Ok: <br />