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DOULOS ENVIRONMENTAL INC. SAMPLING INFO TION SHEET <br /> Client Delta Env Sampling Date , <br /> Site 2537 Waterloo Rd 140966 Project No <br /> Stockton, CA Well Designation <br /> Is settip 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 casmg cut level? NO If no,see remarks <br /> Is well cap sealed and locked? NO If no,see remarks <br /> Height of well casmg nscr(in inches) <br /> Well cover type 8"or 12"UV 12"EMCO 8"or I2"BK 8"Chmty <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 Good Farr Poor <br /> Purging Equipment .r .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" 4" 6„ _ 8" <br /> Purge Vol Multiplier K-6 0 65 147 2,61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time. Tune' Calculated purge <br /> Depth of well e - Depth to water O. !a Actual purge <br /> Depth to water <br /> Start purge r 00" Sampling time <br /> Time Temperature E CH Q Turbidity— Volume <br /> ear (� ? <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7/32 AIlenhead <br /> 4"Locking Cap Lock-Dolphin, 9/16 Bolt. _ <br /> 6"Locking Cap Pinned Allenhead(DWP): <br /> Remarks <br /> Signature: <br />