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r <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <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? (kD YES time: hours <br /> Is there standing water in well box? NO ove C Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> Is well cap sealed and locked? NOYE If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO -)V --- 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 _ X Centrifugal pump <br /> Sampled with: Disposal bailer:- k Teflon bailer: <br /> Well Diameter: 2" 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: q19 Calculated purge: U-D 461) <br /> Depth of well: Depth to water; 7 22 Actual purge tD f <br /> Depth to water:61,51 <br /> Start purge: Q Q0 Sampling time: qA Q <br /> Time Temp. E.C. pH Turbidity Volume <br /> o � uil 9 <br /> a 5 9all 2- <br /> 72- <br /> 72- )- 3 <br /> /3 6q 722- <br /> Sample <br /> 2zSample appearance: cAle" Lock: <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 />. Remarks: <br /> Signature: Lei <br /> it <br />