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DOULOS ENVIRONMENTAL.INC. SAMPLING INFORMATION SHEET <br /> Client Delta Env Sampling Date Z6 - 4, 4*' <br /> Site 2537 Waterloo Rd (100966) Project No <br /> Stockton, CA Well Designation ,r�il�t/`�` / <br /> Is setup of traffic control devices required) YES time _hours <br /> Is there standing water in the well box? if Above TOC Below TOC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked9 z NO If no,see remarks <br /> Height of well casing user(in inches) <br /> Well cover type 8"or 12"[N 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 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" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ift <br /> Initial Measurement Recharge Measurement <br /> Time O Time Calculated purge <br /> Depth of well ,,4r Depth to water Actual purge Z <br /> Depth to water <br /> Start purge r ID Sampling time -► <br /> Time Temperature EC pH Turbidity Volume <br /> Z /.+ .3 f <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"Lockmg Cap Pinned Allenhead (DWP) <br /> Remarks <br /> Signature <br />