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' SAMPLING INFORMATION SHEET <br /> Ramage Environmental Sampling Date O <br /> Site San Joaquin County Courthouse Project No <br /> • 2222 East Weber Avenue Well D -- <br /> esignation <br /> Stockton, CA <br /> ' Is setup of traffic control devices required time hours <br /> Is there standing water ni the well box? NO Above TOC Below TOC <br /> Is top of casing cut levels 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"or 12"UV 12"EMCO 8"or 12"SK 8"Christy <br /> 12"Christy 8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Good Fair Poor <br /> Purging Equipment <br /> _2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4"PVC bailer Centrifugal pump <br /> ' Sampled with Disposable bailer-� Teflon bailer Disposable Tubing <br /> Well Diameter 2" 41t 61) $„ <br /> ' Purge Vol Multiplier 16 065 147 2 61 gal/fl <br /> Initial Measurement Recharge Measurement <br /> Time . ' ! Time 2 4 Calculated purge C� <br /> Depth of well / tp Depth to water -4a Z$r Actual purge -vics <br /> Depth to water ro <br /> ' Start purge Sampling time <br /> Time Temperature E C H Turbidit Volume <br /> - <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br />' 2" Locking Cap Lock 7/32 Allenhead <br /> 4"Locking Cap Lock-Dolphin 9116 Bolt, <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> 1 Remarks pI✓ �' Ca�" a <br /> Signature, <br />