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DOOLOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> r Client: v aura Sampling Date: -/1-36 9 <br /> Site: Beagon #419 Project No. :--24-419-01 <br /> 2250 waterloo Road Well Designation: MW- 'C <br /> Stockton CA <br /> Is setup of traffic control devicesrequired? YES Above: hours <br /> TOC Below TOC <br /> Is there standing water in well box'. TSOIf no, see remarks <br /> Is top of casing cut level? p� If no, see remarks <br /> Is well cap sealed and locked? <br /> Height of well casing riser (in inches) : 12" EMCO 8" BKS <br /> Well cover type: 8" UV- 12 UV 36" CNI Other <br /> 12" BK 12" DWP� 12" CNI,�� <br /> General condition of wellhead assembly: Excellent o Fair Poor <br /> 2" disposable bailer V Submersible pump <br /> Purging Equipment: ,� Dedicated bailer <br /> �2" PVC bailer <br /> 4" pVC bailer Centrifugal pump <br /> _ <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> Well Diameter: 2" 4" V 6" 8 ft <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2. 61 gal/ft. <br /> Initial Neasu ement c+ a e e su e e tCalculated purger <br /> Time: �6i3 Time: `1� Actual purge: 7l ►. <br /> Depth of well: 5�.�'7 Depth to water: <br /> Depth to water: "S <br /> Start purge; Sampling time:--// X133 <br /> Time Temp. E.C. pH Turbidity Volume <br /> JILL � <br /> 61 <br /> 62, 9 1147 <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 /> Signature: <br />