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DOULOS ENVIRONMENTAL, INC. SAMPLING INFO TION SHEET <br /> Client Delta Env. Sampling Date /Y6-L.-lcl-Old <br /> Site- 2537 Waterloo Rd 100966 Protect No <br /> Stockton, CA Well Designation <br /> - <br /> Is setup of traffic control devices required? YES tame h <br /> Is there standing water ui the well box? `IV Above TOC ow T <br /> Is top ofcasmg cut level? NO S m <br /> If no,see rearks <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"or 12"LTV 12 EMCO 8"or 12"BK 8"Chesty <br /> 12"Christy 8"M&D,V 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Fair Poor <br /> Purging Equipment 2"disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4"PVC bailerjV `Centrifugal pump <br /> Sampled with Disposable bailer Teflon.bailer Disposable Tubing_ <br /> Well Diameter- 2" _ 4" 6" 80) <br /> Purge Vol Multiplier 016 065 147 O 2 61 gaUfft <br /> Initial Measurement Recharge Measurement <br /> Time 0 Time Calculated purge G op-od <br /> • Depth of well 3-4 � Depth to water sil R-114 — Actual purge J, 6 <br /> Depth to water <br /> Start purge Sampling time -t 2 .-- <br /> Tune Temperature EC pH Turbidity Volume <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced items) <br /> 2"Locking Cap Lock 7132 Allenhead. <br /> 4"Locking Cap Lock-Dolphm. 9/16 Bolt. <br /> 6"Locking Cap Pinned AIlenhead (DWP) <br /> Remarks <br /> Signature' <br />