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f <br /> DOULOS ENVIRONMENTAL COMPANY SAMPt.ING INFORMATION SHEET <br /> Client: U t amar Sampling Date' q- 'M <br /> Site: Beacon #474 Project No. : 4-474-01 <br /> 3440 E Main Street Well Designation: my-1A <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? NO If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in 4- <br /> 1219 <br /> inches) : 12" EMCO 8" BK---- <br /> well cover type: 8" W Other i�^.�° -�. <br /> 12" BK 12" DWP- 12" CNI 36" CNI.^ -- <br /> General condition of wellhead assembly: Excellent ooh Fair Poor <br /> Purging Equipment: 2" disposable bailerSubmersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer _Centrifugal pump <br /> Sampled with: Disposal bailer:_1� Teflon bailer: <br /> Well Diameter: 2" 611 8 <br /> --- <br /> urge Vol. Multiplier: 0. 16 0.65 1. 47 2 . 61 gal/ft. <br /> asu a ent Rechar a Measurement <br /> nitilgl MeTime: 1 Time: Calculated purge: /0, <br /> Depth of well: 76. E Depth to water: Actual purge: 6 �i <br /> Depth to water: <br /> start purge: <br /> Sampling time: ' <br /> Time Temp. E.C. pH Turbidity Volume <br /> -71 <br /> I mal <br /> u <br /> Sample appearance. Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replace em-=­ <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) :� <br /> - Remarks: <br /> l� <br /> Signature: <br />