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DOULOS ENVIRONMENTAu COMPANY SpugPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 7=3 <br /> 10 <br /> Site: 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? YES time: hours <br /> Is there standing water in well box? Y Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" W / 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI er <br /> General condition of wellhead assembly: Excellent oo 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 Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 . 0.65 1. 47 2 . 61 gal/ft. <br /> 1nitia-1 Measurement Recharge Measurement <br /> Time: q. l -Time: �/ ' ,-7Calculated purge: �© <br /> Depth of well: Depth to water: Actual purge: <br /> Depth to water: y4. 3 `7 <br /> Start purge: - SSI Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> o C !' �{�D <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> r 2_". .Locking Cap: Lock #3753 : -. 7„/32 Al.lenhead: <br /> 411- Locking' Cap: Lock-Dolphin: - 9/16 'Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> :s Remarks: <br /> Signature: <br />