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DOULOS ENVIRONMENTAL _JMPANY SAP{ .ING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacgn #419 Project No. : 94-419-Ql <br /> 2350 Waterloo Road Well Designation:_ MW- g <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? NOoEW If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : _ t <br /> Well cover type: 8" UV 12" UV12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other 4- <br /> General condition of wellhead assembly: Excellent 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:,,<_J_0_ Teflon bailer: <br /> Well Diameter: 2" 4",�>< 6" 8" <br /> Purge Vol. Multiplier: 0.16 0. 65 1 .47 2 . 61 gal/ft. <br /> Initial Measurement <br /> Time: Time: Calculated purger 7 <br /> Depth of well: 57 7/ Depth to water: 7 Actual purge: <br /> Depth to water: ,no/ <br /> Start purge: / 1 -,5 9 Sampling time: 12 = l <br /> Time Temp. E.C. pH Turbidity Volume <br /> V Of S1� - 3 /S/o ? YO <br /> • / / Y ?/ '7 . 23 --- <br /> �D -Z /y7 / `7 -/ 7 <br /> 12 (t 6o 7 - /6 ---- <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 /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> • Remarks: <br /> Signature: <br />