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DO'ULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date.'? 1 1�1 <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: hours <br /> Is there standing water in well box? � YES Above TOC Below TOC <br /> Is top of casing cut level? NO <�M 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 12" DWP 12" CNI 36" CNI Other <br /> General condition of wellhead assembly: Excellent ] Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer P Centrifugal pump <br /> Sampled with: Disposable bailer: S Teflon bailer: <br /> Well Diameter: 2" 4n 611 Sol <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Rechaa Measurement <br /> Time: U <br /> O Time: =/r_ Calculated purge: �S` <br /> Depth of well. 63.0 . Depth to water:_ 36 4/ Actual purge: <br /> Depth to water: 37- 85 <br /> Start purge: Sampling time: <br /> Time Temp. E. C. pH Turbidity Volume <br /> 3 Ile <br /> S <br /> :off 2 - q ov 7 43 <br /> - to 6/ 8 3 -7- <br /> Sample <br /> Sample appearance: 96- � Lock: <br /> Equipment replaced: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 />