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DOULOS ENVIRONMENTAL COMPANY SAMPLING I [A-ON SHEET <br /> Client: Ultramar Sampling Date: <br /> [ Site: Beacon_4474 Project No. : 94-474-01 <br /> 3440 E. Main Street Well Designation: MW <br /> Stockton, CA <br /> Is setup of traffic control devices required? IR YES time: hours <br /> Is there standing water in well box? S Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NO E' If no, see remarks <br /> Height of well casing riser (in inches) : _� <br /> Ntr <br /> Well cover type: 8" UV 12" UV 3` 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI -other— <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer %C Centrifugal pump <br /> .j 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 /> ' g / <br /> Initial Measurement Recharge Measurement <br /> Time: 64 ( Time: `! Calculated purge: <br /> Depth of well: J,4. - Depth to water: C 3Actual purge: l3,� <br /> Depth to water 9 z i 1 <br /> EI <br /> Start purge: 7a ! Sampling time: _�j r <br /> Time Temp. E.C. pH Turbidity Volume <br /> j0. 1 6 Z It 76.E 1 <br /> 743 6q, � <br /> 7 ` q sqE / /5 )4�a 3 <br /> Sample appearance:, Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replacedoitem <br /> u <br /> 2 Locking Cap: Loc _ �. <br /> � k #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> L Remarks: <br /> f [� <br /> r - <br /> it <br /> Signature: <br />