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DOULOS ENVIRONMENTAL COMPANY SAriPLING INFORMATION SHEET <br /> • Client: Ultramar Sampling Date: <br /> Site:, Beacon f474_,--^� Project No. : 94-474-01 �1 <br /> 3440 E. Main Street well Designation:. .' <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? (Tg—n) YES Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12 Ir EMCO 811MBK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other Z cc) <br /> General condition of wellhead assembly: ExcellentG� 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: 211 411 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: 1. Time: I ' Z O Calculated purge: <br /> Depth o well: • 4-9 Depth to water: Actual purge: <br /> Depth to water: <br /> Start purge: 1 Sampling time: '� f <br /> Time Temp. E. C. pH Turbidity Volume <br /> I .37 --7 , C 1 <br /> LIZ <br /> 6/"�. <br /> Sample appearance: '��14Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item i <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: J <br /> 4" :L• ocking Cap: Lock-Dolphin: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : l <br /> Remarks: <br /> Signature : ~ <br />