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P +' <br /> DOULOS ENVIRONMENTAL OMPANY SA MNG INFORMATION SHEET <br /> Client: Ultramar <br /> Sampling Date:._ 3 <br /> Site: Beacon #474 Project No. : 94-474-01 L, <br /> Well Designation:_ mss' ^ 7 <br /> 3440 E. Main Street - <br /> Stockton CA <br /> --- <br /> Is <br /> hours <br /> Is setup of traffic control devices required? � YEStim : Below-TOCurs <br /> Is there standing water in well box. � Above see remarks <br /> is top of casing cut level? NO � If no, see remarks <br /> Is well cap sealed and locked? <br /> Height of well casing riser (in inches) : 12„ EMCO 8" BK <br /> Well cover type: 8" UV12 ---��- Other f, '00 C <br /> 12" BK_ 1211 DWP�,�.^ 12" CNI� 36n CNI <br /> General condition of wellhead assembly: <br /> Excellent �- v� Fair Poor <br /> 2" disposable bailer Submersible pump <br /> Purging Equipment: 2„ pVC bailer Dedicated bailer <br /> 4" PVC bailer .=,, Centrifugal pump <br /> Sampled with: Disposal bailer: <br /> Teflon bailer: <br /> Well Diameter: 2" 4 <br /> If 601� 811, <br /> 4.65 1.47 2 .61 gal/ft. <br /> Purge Vol. Multiplier: 0. 16 _ <br /> . Xn't Measurement 'echarae Measurement �_ � <br /> 2 : r : Calculated purge: <br /> Time: GS, C Depth to water: Actual purge: <br /> Depth of well: Z <br /> Depth to water: <br /> Sampling time: <br /> Start purge: � '�0— P <br /> Time Temp. E.C. pH Turbidity Volume <br /> ----------------- <br /> � 3S .So 1 <br /> L G � . � 12 v 7 3G' <br /> Sample appearance: <br /> •G!/L Lock: <br /> Equipment replaced: {Check all that apply} Note condition of replaced• tem-� <br /> Lock �`3753 :�� 7/32 Allenhead: <br /> 2±1 Locking Cap:�� Lock-Dolphin: 9/16 Bolt. <br /> 4 Locking Cap:_ Pinned Allenhead (DWP) : <br /> 61+ Locking Cap: <br /> Remarks: <br /> Signature: <br />