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r' <br /> DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 3 —�S <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? a YES Above TOC Below TOC <br /> Is top of casing cut level? NO 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 12" /FI'[ Q - <br /> General condition of wellhead assembly: Excellent Good Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 411 PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer:_-K Teflon bailer: <br /> Well Diameter: 2" 4"� 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0.65 1.47 2. 61 gal/ft. <br /> Initial Measurement Recharge measurement <br /> Time: Time: O Calculated purge: 3 <br /> Depth of well: 6 • Depth to water:, Yes- 10_ Actual purge: <br /> Depth to water <br /> Start purge: 111 35 Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> 227 7. 11 t <br /> 6� y 0 740 <br /> -7. If <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 />