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DOULOS ENVIRONMENTAL INC, SAMPLING INFORMATION SHEET <br /> Client Delta Env Sampling Date <br /> Site 2537 Waterloo Rd 100966 Project No <br /> Stockton, CA Well Designation —'e <br /> Is setup of traffic control devices required? tune ^hours <br /> Is there standing water m the well box9 NO 9M Above TOC Below TOC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked? G NO If no, see remarks <br /> Height of well casing riser(m inches) <br /> Well cover type 8"or I2"UV� 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CM 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Poor <br /> Purging Equipment 2"disposable bailer —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" 45 <br /> 2 <br /> 6" V <br /> Purge Vol Multiplier 016 0 65 1 47 2 61 gal/ft <br /> Irutial_1VMeasurement Recharge Measurement <br /> Time. Time, A51 -3 p..Calculated purge <br /> Depth of well- Depth to water �- // Actual purge <br /> Depth to water <br /> Startpurge / v Sampling time 'ice <br /> Time Temperature EC PH J� Turbidity Volume oto 749.5" /4 <br /> t . <br /> r , <br /> i <br /> I ' <br /> Sample appearance Lock <br /> Equipment replaced- (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7/3-2 Allenhead <br /> i 4"Locking Cap Lock-Dolphin, 9/16 Bolt. <br /> 6"Loclang Cap pinned Allenhead (DWP) <br /> i <br /> Remarks �ue � e' — <br /> Signature <br />