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DOULOS ENVIRONMENTAL. INC. SAMPLING INFORMATION SHEET <br /> Client Delta Env Sampling Date w <br /> Site 2537 Waterloo Rd 100966 Project No <br /> Stockton, CA Well Designation ey <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut levels em If no,see remarks <br /> Is well cap sealed and locked? NO JW IIf no,see remarks <br /> Height of well casing riser(in inches) 15 IZI-9 <br /> Well cover type 8"or 12"UV V0 "12"EMCO 8"or 12"BK 8Christy <br /> 12"Christy 8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Porneco Other <br /> General condition of wellhead assembly Excellent Good Pair Poor <br /> Purging Equipment 2" disposable bailer Submersible,pump <br /> 2" PVC bailer Dedicated bailer <br /> 4"P C bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" r� 6" S" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time O 41- Time J 3 :,<Z:1 Calculated purge . <br /> Depth-of well 0.d� Depth to water & q.ZO Actual purge <br /> Depth to water <br /> Start purge , :3 S Sampling time I -3 - S <br /> Time Tern erature E C pH- Turbidity Volume <br /> Zr- <br /> Sample appearance Lock /y <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. 9116 Bolt. <br /> 6"Locking Cap Pinned Allenhead(DWP) <br /> Remarks <br /> Signature' <br />