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DOULOS ENVIRONMENTAL,INC. SAMPLING INFORMATION SHEET <br /> Client Delta Env Sampling Date ' ' loc., <br /> Site 2537 Waterloo Rd (100966) Protect No <br /> Stockton, CA Well Designationy td <br /> Is setup of traffic control devices required? YES time _hours <br /> Is there standing water in the well boxy &i;k <br /> Above TOC Below TOC <br /> Is top of casing cut level? NO If no,see remarks <br /> Is well cap sealed and locked9 NO If no,see remarks <br /> Height of well casing riser(in inches) <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Christy 8"M&D 12"M&D__ 12"DWP <br /> 12"CNI 36"C1VI 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 -)e bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" S" <br /> Purge Vol Multiplier 16 065 147 2 61 gal/ft <br /> Initial Measure ent Rechari?e Measurement <br /> Time ,/ Time ' e Calculated purge l <br /> Depth of well Depth to water Actual purge 45 <br /> - <br /> Depth to water Z <br /> Start purge 0 Sampling time ` 70 <br /> Time Temperature E C pH Turbidity Volume <br /> ��f� ? 0 - r <br /> .Iz Y .39 <br /> ` / <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"Lockmg Cap Lock-Dolphin "6 Bolt <br /> 6"Locking Cap Pinned Allenhead (DVS) <br /> Remarks <br /> Signature' <br />