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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 V f ^^ <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(in inches) <br /> Well cover type 8"or l2"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"M&D 12"M&D �/ 12"DP <br /> 12"CNI 36"CNI 12"Porneco a Other <br /> General conditton of wellhead assembly Excellent Good Fair 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" 4" 6" g„ <br /> Purge Vol Multiplier 0 16 065 1 47 2 61 gaUft <br /> Initial Measurement Recharge Measurement <br /> Time 2 157t Time -//JP' Calculated purge . <br /> Depth of well Depth to water _ r Actual purge <br /> Depth to water tl <br /> Startpurge I/00 Sampling time 3 �' <br /> Time Temperature EC PH Turbidity Volume <br /> 1 A06 <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap Lock 7132 Allenhead <br /> 4"Locking Cap Lock-Dolphin ` 9/16 Bolt. <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks <br /> Signature' <br />