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•� DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client; Ultramar Sampling Date: 10-13 <br /> Site: Beacon #610 _ Project No. : 94-610-01 <br /> 3300 Waterloo Road Well Designation: MW- 6 �. <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 If no, see remarks <br /> Is well cap sealed and locked? NO E If no, see remarks <br /> Height of well casing riser (in Inches) : <br /> Well cover type: 8" LTV 12" UV 12" EMCO 811 BK <br /> 12" BK 12" DWP 12" CNI 36" CNI Otherll�A <br /> General condition of wellhead assembly: Excellent oo 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: Disposal bailer:- )( Teflon bailer: <br /> Well Diameter: 2" 4" X 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0.65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br />• Time: Hol _ Time: /D) Calculated purge: L11 01.4 <br /> Depth of well: Depth to water: 7 3 .5 1 Actual purge: c4141_ <br /> Depth to water: <br /> Start purge: 1115 _ Sampling time: 1D5 <br /> Time Temp. E.C. pH Turbidity Volume <br /> JD 4�3 <br /> r z.4 o -71 Zb � <br /> 0-50 .L, W e03 6 <br /> sba {> r, OLI I 6A 1 '7' <br /> Sample appearance: CA91nd Lock: 3� <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 />