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DOULOS ENVIRONMENTAL INC, SAMPLING INFORMATION SHEET <br /> Client Delta Env Sampling Date <br /> Site 2537 Waterloo Rd (100966) Protect No <br /> Sto9kton, CA Well Designation- <br /> Is setup of traffic control devices required? YES time h <br /> Is there statadmg water in the well box? N Above TOC w TO <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 nser(m inches) ki f <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"M&D_ 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Goode Fair Poor <br /> Purging Equipment 2"disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4" VC bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer IDisposable Tubing <br /> Well Diameter 2" _ ¢"_ 6" <br /> Purge Vol Multiplier 016 065 147 2.6I gal/ft <br /> Initial Measurement Recllar a Measurement <br /> Time 7 Xo.. Time Calculated purge /. <br /> Depth of well W 6 A O _ Depth to water 6'Z Actual purge /, 1 <br /> Depth to water <br /> Start purge /���� ._ Sampling time / "-L- <br /> Time <br /> Tame Temperature E C i pH Turbada Volume <br /> I�s � �� ' <br /> Sample appearance- <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) . <br /> 2"Locking Cap Lock 7/32 Allenhead <br /> 4"Locking Cap, Lock-Dolphin, 9/16 Bolt, <br /> 6"Locking Cap Pinned Allenhead (DWP) — <br /> Remarks <br /> Signature- <br />