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DOULOS ENVIRONMENTAL,INC. SAMPLING INFORMATION SHEET <br /> k <br /> Client Delta Env Sampling Date /0 - <br /> i <br /> Site -2537 Waterloo Rd (100966) Project No <br /> Stockton, CA Well Designation <br /> Is setup of traffic control devices required? N 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) 6 <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Chesty <br /> 12"Christy 8"M&D 12"M&D 12"DWP <br /> 12"CM 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" S" <br /> Purge Vol Multiplier 016 065 — 1 4 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time Tune Calculated purge 3. <br /> Depth of well . c o Depth to water Actual purge � <br /> Depth to water 'Z. <br /> Start purge " Q 5' Sampling time <br /> Time Temperature E C pH Turbidity Volume <br /> z -3S �r� <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, 9116 Bolt, <br /> 6"Locking Cap Punned Allenhead (DWP) <br /> Remarks 0O le* <br /> Signature <br />