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DOULOS ENVIRONMENTAL _OMPANY SAM_ ,ING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 2- — <br /> Site: B aco Project No. : 94-419-01 <br /> 2350 Waterloo Road 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? YES Above TOC Below TOC <br /> Is top of casing cut level? NO gf= 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" UV 12" UV12" EMCO 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: g�EL Teflon bailer: <br /> Well Diameter: 2" 4" L 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> .mm, Initial easure e t Recharge easurement <br /> Time: Time: Calculated purge: 3 «� <br /> Depth of well: Depth to water: y 70 Actual purge: <br /> Depth to water_ 7 1-4 <br /> Start purge: 30 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> I/- 3 4/0 o /03 2 > 10 1 <br /> 0 ! 6 7- SSS L <br /> Il - Sp S9 - � y � o -7 <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 /> , <br /> Remarks: <br /> Signature: <br />