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DOULOS ENVIRONMENTAL,INC. SAMPLING INFORMATION SHEET <br /> Client Delta Env Sampling Date l� • - <br /> Site 2537 Waterloo Rd (1.00966) Project No <br /> Stockton, CA Well Designation <br /> Is setup of traffic control devices required? us time hours <br /> Is there standttig water m the well boxy RN Above TOC Below TOC <br /> Is top of casing out level? NO If no,see remarks <br /> Is well cap scaled and locked? NO If no,see remarks <br /> Height of well casing riser(in inches) <br /> Well cover type 8"or 12"W 12"EMCO 8"or 12"BK 8"Chnsty <br /> 12"Christy 8"M&D_� 12"M&D 12"DWP <br /> 12"CNI 36"CMI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Goode Fair r _ 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 S - Teflon bailer Disposable Tubing <br /> Well Diameter 2" _ 4" 6" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time G Time Calculated purge <br /> Depth of well . Z Depth to water 3.. Actual purge / Z - <br /> Depth to water f `Z <br /> Start purge /d �� Sampling time R d <br /> Time Temperature E C pH Turbidity Volume <br /> "2 9L �o .G9 <br /> Sample appearance. Lack O <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2",Locking Cap Loch 7132 Allenhead <br /> 4"Locking Cap Lock-Dolphin. , 9/16 Bolt. <br /> 6"Locking Cap Pinned Allenhead (DWP). <br /> Remarks <br /> Signature <br />