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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> 4 <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon #474 ... _ _ Project No. 94-474-01 <br />} f_� <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? 0 YES Above TOC Below TOC <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap sealed and locked? NO vT6 If no, see remarks <br /> Height of well casing riser (in inches) : 3 <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI them- <br /> General condition of wellhead assembly: Excellent Goo 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: Teflon bailer: <br /> Well Diameter: 2" 4 i 6'r 8n <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement_ <br /> Time: ';��[ Time: --/1-5- Calculated purge:,. J <br /> Depth^ of well: - Depth to water: ULActual purge:� � <br /> Depth to water: <br /> - <br /> Start purge: 9/b -Sampling time: <br /> f <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7j j <br /> Sample appearance: Lock: <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 /> _ <br /> Signature.. ___-- <br /> ft - <br />