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r y <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 11-1-15 <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? O S 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) : a. <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI they <br /> General condition of wellhead assembly: Excellent ood Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer ��i�Centrifugal pump <br /> Sampled with: Disposable bailer:_/ Teflon bailer: <br /> Well Diameter: 2" 411_A 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: /d,9 Time: L.14 4 Calculated purge: <br /> Depth of well: FZJ bd Depth to water: 61.1.91 Actual purge:K/s fi <br /> Depth to water: 1;*9 7 <br /> Start purge: )_)-D Sampling time: 2-1d6 <br /> Time Temp. E. C. pH Turbidity volume <br /> �-- 1 <br /> 2-3L3 70-6 i 21: __ 3 <br /> Sample appearance: Lock: r;Lt:4'1-W►' <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 />,s Remarks: <br /> Signature: <br />