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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client Ultramar Sampling Date /7--�)-Cfj <br /> Site Beacon#419 Project No 94-419-01 <br /> 2350 Waterloo Well Designation MW- <br /> Stockton.CA <br /> Is setup of traffic control devices requnvV YES, time Hours <br /> Is there standing water in well box? 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 ` E If no,see remarks <br /> Height of well casing riser(in inches) 2=!d <br /> Well cover type 8" UV l2" UV 12"EMCO 8"BK <br /> 12"BK 12"DPW 12"CNI 36" CNI Other <br /> General condition of wellhead assembly Excellent oo Fair Poor <br /> Purging Equipment 2"disposable bailer Submersible pump <br /> 3" PVC bailer Dedicated bailer <br /> 4" PVC bailer1�/ � _Centrtfugal pump <br /> Sampled with Disposable bailer k{ Teflon bailer <br /> Well diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 065 147 261 gam <br /> . Initial Measurement <br /> Time frLf j Time 1l 0q _^ Calculated purge <br /> Depth of well tJ4 Depth to water j�j 2k Actual purge 34. I— <br /> Depth to water 53 4d!,- <br /> Start <br /> fSStart purge 101 Sampling tame /10.S <br /> Time Temperature EC pH Turbidity Vohme <br /> "030 71.7 I <br /> OZ40 70ef 74 1� .21 <br /> J -- <br /> Sample appearance Look <br /> Equipment replaced (Check all that apply) Note condition of replaced items <br /> 2"locking cap Lock#3753 7/32 Allenhead <br /> 4"locking cap Lock-Dolphm 9/16 boh <br /> 6" locking cap Punted Allenhead(DPW) <br /> Remarks <br /> Signature <br />