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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: N,-7_6-26 <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? YES time: hours <br /> Is there standing water in well box' rN S Above TOC Below TOC <br /> Is top of casing cut level? If no, see remarks <br /> Is well cap sealed and locked" NO If no, see remarks <br /> Height of well casing riser (in inches) : q <br /> Well cover type: 8" W 12" UV 12" EMCO:k__ _ <br /> 12" BK 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent (G—ogld 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" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1 . 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time:_ '1 i� Time: 1005 Calculated purge: E.L <br /> Depth of well:R U } __ Depth to water . 6 7! 3 L�- Actual purge: 66 -L ,',, <br /> Depth to water: VC tl <br /> Start purge: U 2 Sampling time: �da5 <br /> Time Temp. E. C. pH Turbidity Volume <br /> �11� 7Q 13� 7r,� <br /> 6,? Sf .2.2-5 -136 2 <br /> Sample appearance: cl&_.�_ � 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: ��L ✓ �'� _ - <br />