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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date:_ /0`/1 ` 97 <br /> Site:-. Beacon #419 Project No. : 94-419-01 <br /> 2350 Waterloo Road Well Designation: MW-3 <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 E If no, see remarks <br /> Height of well casing riser (in inches) : _ 36 <br /> Well cover type: 8" UV 12" UV 12" EMCO Y 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI O er <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 Centrifugal pump <br /> Sampled with: Disposal bailer: 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 Rechar a Measurement <br /> ime: c1a'5 Time: 1 3 Calculated purge: ,C <br /> Depth of well: Depth to water: 6 Actual purge: L61 11 <br /> Depth to water: , <br /> ZAUC! <br /> Start purge: /A/0 T— Sampling time: ).LSS <br /> Time Temp. E. C. pH Turbidity Volume <br /> 31�U 3 7 <br /> a <br /> 7Q , 2-1 746 <br /> 77. c <br /> 11.50 7 4/ <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock 13753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br />• Remarks: <br /> Signature: <br />