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DOULOS ENVIRONMENTAL INC. SAMPLING INFORMATION SHEET <br /> CIient Delta Env Sampling Date: , ' <br /> • Site 2537 Waterloo Rd (100966y_ Project No <br /> Stockton, CA Well Designation - <br /> Is setup of traffic control devices required? time _hours <br /> Is there standing water in the well box? NO 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 riser(m orches), <br /> Well cover type 8"or 12"Uy� 12"EMCO 8"or 12"BK 8"Chnsty <br /> I2"Christy8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Pau Poor <br /> Purging Equipment. 2"disposable bailer >< 'Submersible pump <br /> 2"PVC bailer Dedicated baiter <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 0 147 2 61 gal/ft <br /> Initial Measurement Rechar a Measurement <br /> Tie Time. 12 Calculated purge 6 o 0 <br /> . Depth of well Depth to water, { - Actual purge <br /> Depth to water <br /> Start purge Z Sampling time <br /> Time Temperature E C pH Turbidity Volume <br /> 1 Z z 1 <br /> C9P Zell 415- Q ; <br /> Sample appearance - Lock ' <br /> Equipment replaced (check all that apply) Note cdndition of replaced item(s) <br /> 2"Locking Cap Lock 'I132 Allenhead <br /> 4"Locking Cap Lock-Dolphin. 9/16 Bolt. <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks, <br /> Signature: <br />