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DOULOS ENVIRONMENTAL COMPANY <br /> SAMPLING INFORMATION SHEE1 <br /> Client: Ultramar <br /> Sampling Date: <br /> Site: Beacon i6rzin Project No. : 94-610-01 <br /> 3300 Waterloo Road Well Designation: MW- 7 <br /> Stockton CA <br /> Is setup of traffic control devices required? etf3p YES time: <br /> Is there standing water in well box? —� hours <br /> Is top of casing cut level? YES Above TOC Below TO( <br /> Is well cap sealed and locked? NO If no, see remark; <br /> Height of well casing riser (in inches) : No If no, see remark_ <br /> Well cover type: 811 UV _ „ <br /> 12 UV 12” EMCO--,g 811 BK <br /> 1211 BK— 1211 DWP 1211 CNI 3611 CNI <br /> General condition of wellhead assembly: Excellent Other <br /> Fair Poor <br /> Purging Equipment: 211 disposable bailer <br /> , -Submersible pump <br /> 211 PVC bailer Dedicated bailer <br /> 411 PVC bailer P —Centrifugal pump <br /> Sampled with: Disposable bailer: S <br /> Teflon bailer• <br /> Well Diameter: 291 4rr 611 <br /> 8 if <br /> Purge Vol. Multiplier: 0. 16 <br /> Initial Me urement 0. 65 1. 47 2 . 61 gal/ft. <br /> Time: Rechar a Measurement <br /> Depth of well: 3. 7� TimeCalculated purge: <br /> Dept h tto water• �^ <br /> Depth to water: Actual purge: <br /> Start purge:_ ' SO <br /> Sampling time:_ii-±� <br /> Time Temp. E.C. <br /> PH Turbidity Volume <br /> Sample appearance: <br /> Lock: ...�, <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 211 Locking Cap: Lock #3753 : <br /> 41' Locking Cap:~� --- 7/32 Allenhead:�� <br /> 611 Locking Cap: ' Lock-Dolphin: 9/16 Bolt: <br /> �— Pinned Allenhead (DWP) : <br /> Remarks: <br /> Signature: /I <br />