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SAMPLING INFORMATION SHEET <br /> Ramage EnvironmentalSampling Date <br /> Site San Joaquin County courthouse Project No <br /> ' 2222 East Weber r AVen i Well Designation <br /> Stockton, CA <br /> Is setup of traffic control devices required? YES <br /> Is there standing water to the well boxl e e hours <br /> NO <br /> Is top of casing cut leveAbove TOC Below TOC <br /> h <br /> NO If no,see remarks <br /> Is well cap sealed and locked? — NO <br /> Height of well casing riser(in inches) If no, see remarks <br /> Well cover type 8"or 12"W 12"EMCO 8"or 12"BK <br /> 12"Christy 8"M&D $„Christy <br /> 12"M&D 12"DWI' <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> General condition of wellhead assembly ExcellenttiGood Fair <br /> ' Poor <br /> ' Purging Equipment 2"disposable bailer _ Submersible pump <br /> 2"PVC bailer -Submersible <br /> bailer <br /> _4y' VC bailer <br /> ' Sampled with Disposable bailer Centrifugal pump <br /> Teflon bailer Disposable Tubing_ <br /> Well Diameter 2"_ 4" 6" $„ <br />' Purge Vol Multiplier 016 065 147 —� <br /> Initial Measure ent 2 61 gal/ft <br /> Rechar Measurement <br /> Time 2 Time Calculated purge <br /> Depth of well Depth to watero .S Actual purge <br /> Depth to water ev ,_ <br />' Start purgeZE Sampling time =�✓` C� <br /> Time Tem erature E C H 'i'urbidit Volume <br /> ' _00e . <br /> [J ,F ly <br />' Sample appearance Lock <br /> Equipment replaced (check all that apply) Note cbndition of replaced item(s) <br />' 2" Locking Cap Lock 7/32 Allenhead <br /> 4"Locking Cap Lock-Dolplim. 9/16 Bolt; <br /> 6"Locking Cap Pinned Allenhead (DWP) <br />' Remarks <br /> Signature, <br />