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DOULOS ENVIRONMENTAL )DXPANY SA :,ING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 4;, `� 9 <br /> Site: Beacon x`419 __. Project No. : 14-419 01 <br /> 2350 Waterloo Road Well Designation: MW_ b <br /> Stockton, CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? N Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NIf no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV12" UV )<, 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI her <br /> General condition of wellhead assembly: Excellent oo 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:-75--F Teflon bailer: <br /> Well Diameter: 211 4" 6" 804 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Ahinitial Measurement Recharge Measurement <br /> Time: S t E Time: !d = yC Calculated purge: �{ 4. 0a( <br /> Depth of well: Depth to water: W/ GO Actual purge: I (a <br /> Depth to water: L o , 7 t <br /> Start purge: 10 - 1 9 Sampling time:__. <br /> Time Temp. E.C. pH Turbidity Volume <br /> (0 '-3 I 6o & , 5- 7 _715(o ��- <br /> 4 :3 (� Co , (o 97 7, 51 7> <br /> to : 3 (v `moi -b -7 , 4q <br /> Sample appearance: Lock: ` <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) :,_ <br /> Remarks: <br /> Signature: �,� <br />