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DOUL08 ENVIRONMENTAL OMPANY SPS LING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: -. <br /> Site: Beacon 474 Project No. : 94-474-01 <br /> 3440 --E. Main Street Well Designation: N.- vw-[ <br /> tockton 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? <� If no, see remarks <br /> NO <br /> Is well cap sealed and locked? If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other/ ''p 0- c <br /> General condition of wellhead assembly: Excellent (G6`60 Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer X Centrifugal pump <br /> Sampled with: Disposal bailer: { Teflon bailer: <br /> Well Diameter: 2"-X— 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge -Measurement <br /> Time: I rrn n Time: ! ! r Calculated purge: <br /> Depth of well* 6S /5 Depth to water: Actual purge: :# <br /> Depth to water:�fi I'.97T <br /> Start purge: Sampling time: E �� <br /> Time Temp. E.C. pH Turbidity volume <br /> 105 <br /> DO 41 14 <br /> Sample appearance: Lock: 4�► -�.P <br /> Equipment replaced: - (Check all that apply) - Note condition of replaced item _= <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />