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DOULOS ENVIRONMENTAL INC. SAMPLING INFORMATION SHEET <br /> Client Delta Env Sampling Date ' J*R'�_ Cel <br /> • Site 2537 Waterloo Rd 100966 Project No <br /> Stockton, CA Well Designation l�-• <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water m the well boxy19 g <br /> Above TOC Below TOC <br /> Is top of casing cut leve19 NO If no, see remarks <br /> Is well cap sealed and locked? � NO If no, see remarks <br /> Height of well casing riser(m inches) <br /> Well cover type 8"or 12"UV_,kOo 12"EMCO 8"or 12"BK 8"Chnsty <br /> 12"Chnsty8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI �� 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Faukr Poor <br /> Purging Equipment 2" disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4'1 PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer .�.e Teflon bailer Disposable Tubing_ <br /> Well Diameter 2" 4" 3<7�' _ 6" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Rechar a Measurement <br /> Time Time v f,.rz Calculated purge o <br /> Depth of well F'Y. Depth to water Actual purge 20 <br /> Depth to water & Z <br /> Start purge / L Z Sampling time . <br /> Time Temperature E C pH TurbidiV Volume <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced itern(s) <br /> 2"Locking Cap Lock 7/32 Allenhead. <br /> 4"Locking Cap Lock-Dolphin, 9116 Bolt. <br /> 6"Locking Cap Pinned Allenhead(DWP) <br /> Remafks <br /> Signature <br />