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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> iS-Ite:� Beacon-#419 _ _ Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation:_ MW-_J _ <br /> Stockton, CA <br /> Is setup of traffic control devices required YES time: hours <br /> Is there standing water in well box? 2 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 inchesy. � <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: _1 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. Time: � Calculated purge: <br /> Depth of well: d�.S _ Depth to water: 5 4 nl Actual purge: 1-2-3 9 <br /> Depth to water: flr.72 <br /> Start purge: SID Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> 1 i 70, <br /> Sample appearance: Lock: 11 <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 /> 40 Remarks: <br /> Signature: <br />