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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: '�l'01j <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? Y-ES time: — hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? IC no, see remarks <br /> Is well cap sealed and locked? NO ly KH If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI General condition of wellhead assembly: Excellent ether <br /> 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: Disposal bailer: l' 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 />. <br /> Time: 1140 Time:� 2-1-3 Calculated purge: . Q <br /> Depth of well: Depth to water: S 6 . y�L Actual purge r <br /> Depth to water: <br /> .. <br /> Start purge:_I. S Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 6 q 717 ---� <br /> 3-05 CC a S 7 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Ailenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Boit: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />