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' DOULOS ENVIRONMENTAL,INC. SAMPLING INFORMATION SHEET <br /> Client ENSR Sampling Date 2 a S <br />' Site Stockton Scavenger Association Project No <br />' 1240 Navy Dnve„Stockton Well Designation <br />' Is setup of traffic control devices required S time hours <br /> Is there standing water fn the well box9 NO 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 inches) <br /> Well cover type 8” or 12"UV 12"EMCO 8" or 12"BK 8"Christy <br /> 12"Christy 8"M&D _ 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other.3 r c G l e%6 <br /> General condition of wellhead assembly Excellent Good_ 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 Disposable bailer Teflon bailer Disposable Tubing______ <br /> Well Diameter 2" 4"�<_ 6" $" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time /:aT- Time Calculated purge ' <br /> Depth of well Depth to water Actual purge ` <br /> Depth to water -5 <br /> Start purge /J . :5z� Sampling time <br /> Time Temperature E C H Turbidity_ Volume <br /> Sample appearance n_YCLA't Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2" Locking Cap Lock 7/32 Allenhead <br /> 4"Locking Cap Lock-Dolphin 9/16 Bolt <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks <br /> Signature, <br />