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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Dater <br /> • Site: Beacon #419 Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW-k, <br /> Stockton, CA <br /> Is setup of traffic control devices required? o YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap sealed and locked? NO E If no, see remarks <br /> Height of well casing riser (in inches) : L4 <br /> Well cover type: 8" UV 12" UV 12" EMCO�' _- 8" BK <br /> 12" BK 1211 DWP 12" CNI 3611 CNI Other <br /> General condition of wellhead assembly: Excellent Goo 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",4f 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Adhnitial Measurement Recharge Measurement <br /> me:_ /" 7 Time: 4tl -Y Calculated purge: C7 <br /> Depth of well : Depth to water: X Lf 30 Actual purge: 67 7 h <br /> Depth to water: S�- /S - <br /> Start purge: �-�-f _ Sampling time: J 0 6 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7 7N /Jl / <br /> 45? <br /> 3 <br /> z� 6 z 716 Lf <br /> Sample appearance: 1 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 /> wemarks: <br /> Signature: <br />