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DOULOS ENVIRONMENTAL COMPANY <br /> SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon 610 Project No. : 94-610-01 <br /> 3300 Waterloo Road Well Designation: MW- <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: <br /> Is there standing water in well box? hours <br /> Is top of casing cut level? YES Above TOC Below TOC <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : NO If no, see remarks <br /> Well cover type: 811 UV 12++ UV 12 11 EMCO <br /> 12" BK 12" DWP 12 " CNI $" BK <br /> General condition of wellhead assembly: Excellent GoodherFa?r Poor <br /> Purging Equipment: 2" disposable bailer <br /> 2" PVC bailer Submersible pump <br /> Dedicated bailer <br /> 4" PVC bailer ``// Centrifugal pump <br /> Sampled with: Disposable bailer: h Teflon bailer: <br /> Well Diameter: 2" 4rr2L Err 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 x. 47 <br /> Initial Measurement 2 . 61 gal/ft. <br /> Rechar a Measurement <br /> Time: Time: 1 : O Calculated purge: 67 .3 <br /> Depth of well: 6 Depth to water: `(e9- /4 <br /> Depth to water:— <br /> Actual purge: <br /> Start purge:__t� 5 Sampling time:. <br /> Time Temp. E. C. pH Turbidit <br /> Y Volume <br /> -74/0 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced .it <br /> 2" Locking Cap: Lock #3753 • 7/32 Allenhead• em <br /> 4" Locking Cap: Lock-Dolphin: •---�- <br /> 6 Locking Cap: 9/16 Bolt:,, <br /> Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: <br />