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L <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: /I;II "9 7 <br /> iSite: 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? ® 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 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 Other <br /> General condition of wellhead assembly: Excellent Goo Fair Poor <br /> Purging Equipment: 2" disposable bailer X_Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:_S Teflon bailer: <br /> Well Diameter: 2" 4"_2�1 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2. 61 gal/ft. <br /> itial Measurement Recharge Measurement 7/0 <br /> ime: Time: o Calculated purge: <br /> Depth of well: Js 2 1/ Depth to water: 5 7 Actual purge: 7 •o <br /> Depth to water• S > '!tea <br /> Start Purge: 2 ' 3o Sampling time: ' 3 <br /> Time Temp. E.C. pH Turbidity Volume <br /> Z/ <br /> G fr,3 'ail 7Li3 <br /> Sample appearance: C�-�-{� Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br />*Remarks: <br /> Signature: <br />