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DOULOS ENVIRONMENTAL COMPANY SAMPLING INF'O'RMATION SHEET <br /> Now <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon #419 Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW- <br /> Stockton CA <br /> Is setup of traffic control devices required' NO 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? NO E If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV2" CO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI 0-ther <br /> General condition of wellhead assembly: Excellent ood 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:_X� Teflon bailer: <br /> Well Diameter: 2" 4" �' \ 61' 811 <br />• Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Rechar a Measurement <br /> Time: /C3 ' �I 3Time: D Calculated purge: <br /> Depth of well. 3' s 7 Depth to water: 3 Actual purge: <br /> Depth to water: ���- l <br /> Start purge:_ Sampling time:- /1 , 31 <br /> Time Temp. E. C. pH Turbidity Volume <br /> Sample appearance: L 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 /> rl <br /> signature: '�- <br />