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DOULOS ENVIRONMENTAL bMPANY SAI SING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon Project No. : 94-419-21- <br /> 2350 Waterloo Road Well Designation: yw r( <br /> Stockton CA <br /> Is setup of traffic control devices requirdd? YES time: hours <br /> Is there standing water in well box? C5 YX44 Above TOC Below TOC <br /> Is top of casing cut level? NO AYES' If no, see remarks <br /> Is well cap sealed and locked? NOOii� If no, see remarks <br /> Height of well casing riser (in inches) : f Z <br /> Well cover type: 8" UV 12" UV 12" EMCO 811 BK <br /> 12" BK 12" DWP 12" CNI 36" CNI — Other-2L, Z —K6 K <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: .- Teflon bailer: <br /> Well Diameter: 2" x 4" 6" 8" r <br /> Purge Vol. Multiplier: 0. 16 0.65 1. 47 2 . 61 gal/ft. <br /> Initial e su e e t Recharge Measurement <br /> Time: -s �4- Time:_[,-- 7, S Calculated purge: 9 '� <br /> Depth of well: 4 3, 9 0 Depth to water: 'f l Zd Actual purge: <br /> Depth to water: 1&0, c► -7- <br /> Start <br /> Start purge: r S Sampling time: � r 2 <br /> Time Temp. E.C. pH Turbidity Volume <br /> �7, Z X155 -7 (a <br /> � 7 �-? , tip R 7, 4 3 <br /> (o7 , + t -7 7, 37 <br /> �- <br /> Sample appearance: Lock: N C:> N E <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 /> rt i nnatttrw• 'W <br />