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R <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon #419 _ Project No. : 94-4-19-01_ <br /> 2350 Waterloo Road Well Designation: MW- 1 <br /> Stockton, CA <br /> Is setup of traffic control devices required? IO YES t 'nepco <br /> : hours <br /> Is there standing water in well box? N TOC Below TOC <br /> Is top of casing cut level? NO I , see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI they <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" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: /Ij% Time: /L L-: ; Calculated purge: s, 7,,) <br /> Depth;of ywel l: x :-� Depth to water: 9�b Actua 1 purge: 66 7 i <br /> Depth to water: tlf � <br /> Start purge: J i-/ 7 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 1L33 Sfir, <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Balt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br />. Remarks: <br /> Signature: �' "s <br />