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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon 1419 Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW- <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? N S If no, see remarks <br /> Is well cap sealed and locked? NO JT5 If no, see remarks <br /> Height of well casing riser (in inched) : _ 12 <br /> Well cover type: 8" UV 12" UV ^_ 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent G o 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: lhz Time: 1105 Calculated purge: S� <br /> Depth of well:_ 6--16Q Depth to water: R 9 Actual purge: 50.0 .� <br /> Depth to water: L,7 47 L <br /> Start purge: L45 Sampling time: /106 <br /> Time Temp. E.C. pH Turbidity Volume <br /> ---------- <br /> 16 <br /> ----le <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 />