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x} <br /> DOULOS ENVIRONMENTAL :OMPANY Sp LING INFORMATION SHEET <br /> Client: Ultramar sampling Date: 3`25`R � <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? YES Above TOC Below TOC <br /> Is top of casing cut level? ro If no, see remarks <br /> Is well cap sealed and locked? NO <br /> If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV- 12" UVB., 12" EMCO 811�� <br /> K _ <br /> 12" BK 12" DWP 12" CHI 36" CNI other_/I-'/ 0! E4 <br /> 22 <br /> General condition of wellhead assembly: Excellent <ggo> 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:-,( ,P Teflon bailer: <br /> Well Diameter: 2" 4 691 81f <br /> Purge ,Vol.- Multiplier: 0. 16 _ 0,65 1.47 2 . 61 gal/ft. <br /> initial Measurement Rec ar a Measurement Calculated purge: <br /> _ <br /> Time:, 7=®� _ Time: <br /> Depth of well: 7a- 5,5' <br /> Depth to water: 7 Actual purge: S `7� <br /> Depth to water: <br /> Start purge-, 2�1: S Sampling time: "7 <br /> Time Temp. E.C.' pH Turbidity Volume <br /> G <br /> �! : ®S ':5- .0 l2 yd `7. 3C z <br /> �3 = I0 6�' /* 12 /d -7 - 3 ! <br /> 7. 3 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note cond:.tion of replaced tem-- <br /> 211 Locking Cap: Lock 03753 : 7 /32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin:. 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />