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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- 1 _ ___ <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? a 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 ES If no, see remarks <br /> Height of well casing riser (in inches) : Iq <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 Good Fair Poor <br /> 3 AA" <br /> Purging Equipment: .k 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer �T�Centrifugal pump <br /> Sampled with: Disposal bailer:_ Teflon bailer: <br /> Well Diameter: 2" 4" 1Y 6" 81+ <br /> Purge Vol. Multiplier: 0 . 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Rechar a Measurement <br />•Time: 44�41 Time: lli4K Calculated purge: <br /> Depth of well: Depth to water: 7S'_In Actual purge: 2.9 h <br /> Depth to water: V3 19_ <br /> Start purge: Sampling time: /)450) _ <br /> Time Temp. E.C. pH Turbidity Volume <br /> �s <br /> 7Zlj0� <br /> i 7 - <br /> 3 <br /> 76 6 1 _1A 3 3 _ 2 <br /> 11 z 76 13tl�� <br /> Sample appearance: Lock: _ 4��� <br /> ori � -�inm� loom <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: -L�., <br />