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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 3-1.5 -17 <br /> Site: Beacon 610 Project No. : 94-610-01 <br /> 3300 Waterloo Road Well Designation: MW- v�- <br /> Stockton CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? <FSFQ> YES Above TOC Below TOC <br /> Is top of casing cut level? NO dfM If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 1 12" DWP 12" CNI 36" CNI - Other- <br /> General <br /> therGeneral condition of wellhead assembly: Excellent ood 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. ;; 42 Teflon bailer: <br /> Well Diameter: 2" 411_ 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1.47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: [ 2 = N Time: O Calculated purge: S2 ' amu/ <br /> Depth of well: '577.3y Depth to water: 7 Actual purge / <br /> Depth to water..__34. <br /> Start purge: Sampling time: 3 �( <br /> Time Temp. E.C. pH Turbidity Volume <br /> • 2 6W 3 7 2 <br /> Sample appearance: 'L Lock: G • <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock #3753 : 7/32 Allenhead: <br /> 4" Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature• <br />