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DOUL08 ENVIRONMENTAL _OMPANY SAM_ ,ING INFORMATION SHEET <br /> Client: Ultramar Sampling <br /> P g Date: <br /> Site: Beacon #419 Project No. : 94-419-01 -- <br /> 2350 Waterloo_-BOAA Well Designation: <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 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" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other 9 —€cd <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: <br /> Well Diameter: 2" 4"-,Z— 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0.65 1. 47 2 . 61 gal/ft. <br /> Amb..Initial Neasurement Recharge Measurement L/ 7 0 <br /> Time: Calculated purge: <br /> Depth of well: '!�f y Depth to water: 7� " Actual purge: 7 V <br /> Depth to water• ' <br /> • p <br /> �- 'i�� Sampling0 s <br /> Start purge: time. Gf <br /> i <br /> Time Temp. E.C. pH Turbidity Volume <br /> <P- y 3 ,5" - 7 '?r 7 G <br /> �= so �� • Y6 3 6 y <br /> Sample appearance: l� G a•� Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />