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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 11- 1'9 5 <br /> iSite: Beacon #4.19 _ Pro]ect No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW- a. <br /> Stockton, CA <br /> Is setup of traffic control devices required? NO YES time: hours <br /> Is there standing water in well box? O 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) : 1 <br /> Well cover type: 8" UV 12" UV 12" EMCO_,�C_ 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI ther <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 �1 Centrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> Well Diameter: 2" 411 6" 8rr <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharae Measurement <br /> Time:-- /1 q Time:_ f L.-K Calculated purge:.10 Y <br /> Depth of well: rii 1-3 Depth to water;—.6 " Actual purge: 30 4 4 <br /> Depth to water:- K-1,orf <br /> Start purge: ' _ Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 7; 1 <br /> ' 42- 'f / 1-i <br /> 130 <br /> Sample appearance: 411-� - Lock: �; F. <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 /> SRemarks: <br /> r <br /> Signature: ' ' t <br />