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DOULOS ENVIRONMENTAL ..OMPANY SAM_ ,ING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 1 2- <br /> Site: <br /> Site: Beacon j`4 9 _ Project No. : 94-419-01_ _ <br /> 2350 Water o RoSISA Well Designation:_ MW- S <br /> Stockton CA <br /> Is setup of traffic control devices required? -00R YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? 4 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" UV12" UV 12" EMCO 8" BK <br /> 12" BK 1211 DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent Fair Poor <br /> !I <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: <br /> Well Diameter: 2" 491-4��— 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> • Initial Measurement ReGliarge Meas3arement <br /> Time: ? ' / 9 Time: Calculated purge: / 7 <br /> Depth of well. �3• s Depth to water: �� Actual purge: L <br /> Depth to water: 7 <br /> Start prurge: �- Z 4 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> x ' ;- 3 s f /s -7 S ? ---� 1 <br /> f= -7 7 - yc 3 <br /> 2 y D • '7 l y 60 -2 Y1 L `-- <br /> Sample appearance: Lock: <br /> 100, <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 /> Remarks: <br /> Signature: <br />