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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: /1-6Ji� <br /> Site: 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? (jR� YES time: hours <br /> Is there standing water in well box? NO YZove OC Below TOC <br /> Is top of casing cut level? NOIf no, see remarks <br /> Is well cap sealed and Locked? NO E If no, see remarks <br /> Height of well casing riser (in inches) : 9- <br /> Well cover type: 8" UV 12" W 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI ther <br /> General condition of wellhead assembly: Excellent oa Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer et Centrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> Well Diameter: 2" 4f 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br />. Time: 7r4o Time:^ 9-11 Calculated purge: <br /> Depth of well : ?'Kz-6 Depth to water: �l , �� Actual purge: 69 . <br /> Depth to water: S!C 6,r, <br /> Start purge: S'�l Sampling time: �r .Z <br /> Time Temp. E. C. pH Turbidity Volume <br /> z 0 6q V 7Jtq <br /> i50 {r` 7)-.L, <br /> 6,75 210 <br /> Sample appearance: Lack: <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 />