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DOULOS ENVIRONMENTAL COMPANY SAMI.L,ING INFORMATION SHEET <br /> Client: UltramaSampling Date: "L2 <br /> Site: Beacon 09474 <br /> 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: <br /> hours <br /> TOC Below TOC <br /> Is there standing water in well box. qO If no, see remarks <br /> Is top of casing cut level? NOIf no, see remarks <br /> Is well cap sealed and locked? NO '� <br /> Height of well casing riser (in inches) : �` �� 8„ BK_ <br /> Well cover type: 8" UV�„^_ 12 UV 12 EMCO r <br /> 12" BK 12" DWP 12" CNI 36" CNIOther P <br /> General condition of wellhead assembly: Excell;_ntI600 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:-.I--r Teflon bailer: <br /> Well Diameter: 2" 4 6 <br /> 11 811 <br /> 0.65 1. 47 2 .61 gal/ft. - <br /> urge Vol. Multiplier: 0' 16 Recha e _Measuremen <br /> t easurement ��q. <br /> Time: Time: ' �-� "�_ Calculated purge: � � <br /> Depth. of well: <br /> ,• 4 Depth to water: q � Actual purger f <br /> Depth to water: • u <br /> Start purge:wSampling time: <br /> Time Temp. <br /> E.C. pH Turbidity Volume <br /> 1Ll? l 70-6 <br /> L <br /> Sample appearance: Lock:'' <br /> Equipment replaced: (Check all that apply) Note condition of replaced item, <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt. <br /> 6" Locking Cap: Pinned Allenhead (DWP) :�^ <br /> _Mh <br /> Remarks: <br /> Signature. <br />