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DOQLOS ENVIRONMENTAL _. XPANY SAID :ING INFORMATION SHEET <br /> Clients__�Ultramar Sampling Date: q'V 17L <br /> Site:,__Beacon 1419 Project No. : 94-419-01 <br /> 2350 Waterloo 8QAs Well Designation: _ _MW-.L(_ <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? NOIf no, see remarks <br /> Height of well casing riser (in inches) <br /> 3 <br /> Well cover type: 8" UV 12" UV _ 1219 EMCO - s" HK_ <br /> 12" BK— 12" DWP 12" CNI 36" CHI Other <br /> General condition of wellhead assembly: Excellent Qo d 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" 6" 8" <br /> Okgo <br /> Vol. Multiplier: 0.160.65 1.47 2. 61 gal/ft. <br /> Initial_ Measurement Re-chgrge Measurement <br /> Time:— i!_t� Time: :.5 Calculated purge: {�] <br /> Depth of well:_ 7 f Depth to water: 1 r 3.3 Actual purge: 514 7 �. <br /> Depth to water: 146_K_c4_ <br /> Start purge:_=3 6 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 2--7-1 741. 1-0 6 <br /> �- - <br /> 70-5 <br /> Sample appearance: 4: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 03753: 7/32 Allenhead:,� <br /> k4" Locking Cap: Lock-Dolphin: 9/16 Bolt:�____, <br /> 6" Locking Cap: Pinned Allenhead (DWP) :,_„�„� <br /> Remarks: <br /> i anAturse. <br /> /k! <br />