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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon 41rin Project No. : 94-610-01 <br /> 3300 Waterloo Road Well Designation: MW- .46, <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 voyZE> If no, see remarks <br /> Is well cap sealed and locked? NO Z1W 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 I A5-'v?T-C-O <br /> General condition of wellhead assembly: Excellent o_T> Fair Poor <br /> Purging Equipment: 2" disposable bailer <br /> �� - ,Submersible pump <br /> 2 PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: S P Teflon bailer: <br /> Well Diameter: 2" 411 611 811 <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Rechar a Measurement <br /> Time: I vo 73 - �� Time: Calculated purge:`_L_S__ <br /> Depth of well: 3 Depth to water: g Actual purge: r3 s <br /> Depth to water. 7 y. <br /> Start purge: = Sampling time:. 6 <br /> Time Temp. E. C. pH Turbidity <br /> / Volume <br /> � ° -7- tv <br /> Y CA -7o6 ------ <br /> 3 <br /> �[ �{ D <br /> Sample appearance: Lock: <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 />