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h p <br /> DOULOG ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon 1419Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW-3 <br /> Stockton, CA <br /> Is setup of traffic control devices required? O YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? O If no, see remarks <br /> Is well cap sealed and locked? NO (!!DR If no, see remarks <br /> Height of well casing riser (in inches) : 39 <br /> Well cover type: 8" UV 12" UV 12" EMCO,�(� 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 T centrifugal pump <br /> Sampled with: Disposal bailer: /r_ 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: ,?56 Time: 10,1 Calculated purge <br /> S�UJ3 <br /> Depth of well: . - Depth to water: 71..LL � Actual purge: <br /> Depth to water: 99.7 <br /> Start purge:_ 955 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 951 1 <br /> Itog 7 2- <br /> o Sq I 33 3 <br /> 10/!4s 7 2- <br /> Sample <br /> Sample appearance: 092,41 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: <br />