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DOULOS ENVIRONMENTAL INC. SAMPLING INFORMATION SHEET <br /> Client Delta Env. Sampling Date <br /> _ <br /> Site 2537 Waterloo Rd (100966) Project No <br /> Stockton, CA Well Designation "" <br /> Is setup of traffic control devices required? YES tune hours <br /> Is there staudang water to the well box? Above TOC Below TOC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked? NO If no,see remarks <br /> Height of well casing n (in inches) <br /> Well cover type S"o �' UV_� 12"EMCO S"or 12")3K $"Christy <br /> 12"Christy8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good_ Pair Poor <br /> Purging Equipment 2"disposable ballet Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4"PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer. Disposable Tubing_ <br /> Well Diameter 2" 4" � 6" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge asurement <br /> Time = D .1,Tune } iL Calculated purge4-, <br /> Depth of well 2 Depth to water 4 Actual purge <br /> Depth to water <br /> Start purge }/2 Sampling time, .�Q.. <br /> Time Temperature E C pH Turbidi Volume <br /> �j <br /> 4 <br /> i <br /> Sample appearance. ' _ ^_ Lock <br /> Equipment replaced- (check all that apply) Note condition of replaced item(s) <br /> ' 2"hocking Cap. Lock 7/32 Allenhead <br /> 4"Locking Cap Lock-Dolphin. 9116 Bolt, <br /> 6"Locking Cap Pinned Allenhead(DWP) <br /> Remarks <br /> Signature' <br />