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_ SAMPLING INFORMATION SHEET <br /> Client Ramage Environmental Sampling Date <br /> Site _San Joaquin County Courthouse Project No <br /> r2222 East Weber Avenue Well Designation z r e, " <br />' Stockton, CA <br /> Is setup of traffic control devices required 0 tune hours <br /> Is there standing water in the well box? NO 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"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12" Christy8"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 2" disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br />' 4" PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer isposable Tubing <br /> Well Diameter 2" 4" 6" S" <br /> Purge Vol Multiplier 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time - Time 1 O Calculated purge <br /> Depth of well it Depth to water r 5�5 Actual purge <br /> Depth to water t G/. Gq <br /> tart purge ./Q -'.S ,�}� Sampling time - 0 <br /> Time Temperature E C pH Turbi Volume <br /> o.�, "� ' 3 6 -+fir <br /> ro `` I <br /> amr appearance earance Lock <br /> _ <br />' Elquipment replaced (check all that apply) Note condition of replaced item(s) <br /> "Locking Cap Lock 7132 Allenhead <br /> " Locking Cap Lock-Dolphin 9116 Bolt <br /> " Locking Cap Pinned Allenhead (DWP) <br /> •Remark ''' k ,r `° ► <br /> Signature <br />