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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET 'r <br /> Client: Ultramar Sampling Date: <br /> . Site: Beacon #419 Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW--6 <br /> Stockton, CA <br /> Is setup of traffic control devices required? T�O YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? DO If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : /F� <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 oo 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:—Z-v Teflon bailer: <br /> Well Diameter: 2"-4- 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: 1�>4_g ___ Time: 1141 Calculated purge: <br /> Depth of well: 6<-2? Depth to water: Actual purge: 1/ 1' -I> <br /> Depth to water: 149,36 <br /> Start purge: Ila _ Sampling time: I1 �1 <br /> Time Temp. E.C. pH Turbidity Volume <br /> Q <br /> Sample appearance: t� � 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 />