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DOULOS ENVIRONMENTAL .OMPANY SAN SING INFORMATION SHEET <br /> Client: Ultramar sampling Date: <br /> . Site: Beacon 41 Project No. : 94-412-01 <br /> 2350 Waterloo o 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? 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) : 3 <br /> Well cover type: 8" UV12" UV 12" EMC-O-" �_ 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent o 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:-L?— Teflon bailer: <br /> Well Diameter: 2" 4"'z- 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0.65 1 .47 2 . 61 gal/ft. <br /> Measurement Reqharcze Measure]Me t <br /> ime: `7 =2 Time: cy cop - Calculated purge: <br /> Depth of well: �r S 23 Depth to water: 7 Actual purge: <br /> Depth to water:Y 4C - 2 S <br /> Start purge: y Sampling time: J1 = 3 r <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 <br /> q , ly 16o o Ifyd 7 32 <br /> 9 ' Z �o -� lido 7 • � �' � t3� <br /> `� ' 2 � 64 S �� g � • 2� r <br /> Sample appearance: Lock: P <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 41' Locking Cap: Lock-Dolphin: 9/16 Bolt:�T <br /> 6" Locking Cap: Pinned Allenhead (DWP) :.� <br /> Remarks: <br /> Signature: <br />