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DOULOS ENVIRONMENTAL -OMPANY SAM_ 1ING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: Z ' C7 <br /> • Site: -Beacon 4 Project No. : 24-412-01 _ <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? ES Above TOC Below TOC <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap sealed and locked? NOs If no, see remarks <br /> Height of well casing riser (in inches) : -�- <br /> Well cover type: 8" W 12" UV),, 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 3611 CNI other <br /> M2 General condition of wellhead assembly: Excellent Fair Poor <br /> rotor <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: 2112L 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> gWnitial Measurement c e Measurgment rL / <br /> ime: Time: 160' Zr Calculated purge: <br /> Depth of well: O Depth to water: Y AF 4LO- Actual purge: 12 <br /> Depth to water: `t-'2 - <br /> Start Burge: Sampling time:,, <br /> Time Temp. E.C. pH Turbidity Volume <br /> o • o /• v a <br /> co 7 <br /> �o U 2 � ! 3 /aG � 7•Sv ---�- <br /> �0 -03 <br /> o • !a Y/ • �S --- <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />