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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 10-11-6L4 <br />• Site: Beacon #419Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW- <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? N4 if no, see remarks <br /> Is well cap sealed and locked? NO 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 they <br /> General condition of wellhead assembly: Excellent Goo 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:-_ Teflon bailer: <br /> Well Diameter: 2" 491 _ 6" 8" <br /> Purge Vol . Multiplier: 0 . 16 0 . 65 1. 47 2 . 61 gal/ft. <br /> iInitial Measurement Rechar a Measurement <br /> Time: 01.1s — Time: 103 Y Calculated purge: A <br /> Depth of well: ?14 d-3 Depth to water:_7Lv Actual purge: ;.s <br /> Depth to water: 7144yf <br /> Start purge: 9Lf0 Sampling time: 10410 <br /> Time Temp. E. C. pH Turbidity Volume <br /> q5 0 701 1115 <br /> /000 7o i 1 75 �. <br /> 16q 6 ,L O 3 <br /> Sample appearance: cel, Lock: j <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 />