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' DOULOS ENVIRONMENTAL INC. SAMPLING INFORMATION SHEET <br /> Client ENSR Sampling Date • e ` <br />' Site Stockton Scaven er Association Project No <br /> • r � <br /> 1240 Navy Dnve„Stockton Well Designation <br />' Is setup of traffic control devices required7 time hours <br /> Is there standing water in the well box9 NO Above TOC Below TOC <br />' Is top of casing cut level? NO C2t> If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser(in mcb. s <br /> Well cover type 8”or 12"UV 12"EMCO 8"or 12"BK 8" Chnsty <br /> 12"Chnsty 8"M&D _ 12"M&D 12"DWP <br /> 12"CNI 36"CNII 12"Pomeco Other <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_ ,Y-- <br /> Well Diameter 2" 4" 8" <br />' Purge Vol Multiplier 016 0 e� l 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Tune IZ Time Calculated purge F <br />' * Depth of well �Ca Depth to water Actual purge eea <br /> Depth to water _Zsl � Z <br /> Start purge 7.' Sampling time <br /> Trine Temperature EC pH Turbidity Volume <br /> 6 2/. I <br /> : o <br />' Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) w <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 />