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DOULOB ENVIRONMENTAL )OMPANY SA ',ING INFORMATION SHEET <br /> Client: Ultramar Sampling Date:_64171 1 `�� <br /> Site:— Beacon #419 Project NO. : <br /> � _24-419-01 <br /> 2350 Waterloo Road Well Designation: MW- 3 <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 QKP> If no, see remarks <br /> Height of well casing riser (in inches) : C <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP �CNI�._ 36" CNI Other <br /> General condition of wellhead assembly: Excellent E� 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: s Teflon bailer: <br /> Well Diameter: 2" 411,;�_ 611 Sig <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> AK"44-4ml Measurement Recharge Measurement <br /> ime: 8; 2(o Time: / 2 = 6S' Calculated purge: g �A <br /> Depth of well—.-_F 4 , 16 Depth to water: �� 2 "70 Actual purge:i i �q 1 <br /> Depth to water: Lt 0 . 1 <br /> Start purge:_) 3 o!2" Sampling time: (Z 'Oe;' <br /> Time Temp. E.C. pH Turbidity Volume <br /> r {5� 2b <br /> -7 . 39 3 <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 /> Remarks: <br />