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DOULOS ENVIRONMENTAL �PHPANY SA7 ,ING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site:--Beacon 141 Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: W- <br /> Stockton, CA <br /> Is setup of traffic control devices requirdd? YES time: hours <br /> Is there standing water in well box? O YES Above TOC Below TOC <br /> Is top of casing cut level? 0 If no, see remarks <br /> Is well cap sealed and locked? NOSYE If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: S" UV12" UV__X^, 1201 EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent ao 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" Y 6" all <br />,Purge Vol. Multiplier: 0. 16 0.65 1. 47 2. 61 gal/ft. <br /> Initial..Measurement Regharge. Measurement <br /> Time:SS _ Time: = Calculated purge: <br /> Depth of well: ,(e 3 , 5 5 Depth to water: 4/ • �'3 Actual purge: 9 j <br /> Depth to water: w!::kO, (al <br /> Start purge: c1 = 0 g Sampling time: =,- 7 <br /> Time Temp. E.C. pH Turbidity Volume <br /> T5 z <br /> (O G , (o ^Z^ 1 --7, 44 <br /> 7 <br /> I , K 4 <br /> o � � IZ33 -7, � � 4 <br /> Sample appearance: r 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 /> 611 Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> S�frnatttrn `-!i+' -- <br />