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DOULOG ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: .q <br />. Site: Beacon #419 — Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation:, MW- 5 <br /> Stockton. CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? %R YES Above TOC Below TOC <br /> Is top of casing cut level? No `E$ If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : IL-.- <br /> Well <br /> LWell cover type: 811 UV 12" UV__A_ 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI then <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailer ��Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer t, P Centrifugal pump <br /> Sampled with: Disposable bailer: .S Teflon bailer: <br /> Well Diameter: 2" 411 V _ 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2. 61 gal/ft. <br />. Initial. Measurement Recharge Measurement <br /> Time: _i ni-'7 Time:. !=-7 Calculated purge: 7 L <br /> Depth of well: Q15'5' Depth to water: �f 1`��- Actual purge:_ of L- y� <br /> Depth to water: Lf1 46 <br /> Start purge: 1110 _ Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 11 /L 6 )z- <br /> /// 7 <br /> z/// 7 6-L-) az r, � ul Z <br /> J,2-1 « r 7- <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 /> iRemarks: <br /> Signature: <br />