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' SAMPLING INFORMATION SHEET <br /> Ramage Environmental_ Sampling Date ` <br /> Site San Joaquin County Courthouse Project No <br /> ' 2222 East Weber Avenue Well Designation M <br /> Stockton, CA <br />' Is setup of traffic control devices required time hours <br /> Is there standing water in the well box9 NO Above TOC Below TOC <br /> Is top of casing cut level? NO If no, see remarks <br /> I Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser(m inches) _ <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br />' 12"Christy8" f'toC 12"M&D� 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly Excellent Goode 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 Disposable bailer ^. Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time 2' g ,ro- Time Z , 79 Calculated purge <br /> Depth of well {• 60 Depth to water • Q Actual purge C-f' <br /> Depth to water _j 3 , r S <br />' Start purge r -Z-3 Sampling time <br /> Time Temperature EC pH Turbidi Volume <br /> ARIO P-0-5- 70 <br /> 1 , <br />' Sample appearance - � Lock. fe' <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, 9/16 Bolt, <br />' 6" Locking Cap Pinned Allenhead (DWP) <br /> • Remarks oct <br />' Signature. <br />