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SAMPLING INFORMATION SHEET <br />' Client Ramage Environmental _ Sampling Date <br /> Site _222 East Weber Street Project No <br />' 3f Stockton Well Designation <br /> 3 <br /> 4� <br /> s; Is setup of traffic control devices required9 YES time hours <br /> Is there standing water in the well box? Y S Above TOC Below TOC <br /> Is top of casing cut levels �$O If no, see remarks <br /> Is well cap sealed and locked? NO CQ If no, see remarks <br /> Height of well casing riser(nn inches) <br /> Well cover type 8"or 12" UV 12" EMCO 8"or 12"BK 8" Chnsty______ <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 GoodT Fair Poor <br />' Purging Equipment 2" disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br />' 3 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 16 065 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time Time Calculated purge <br /> ' Depth of well Depth to water - 6 Actual purge <br /> Depth to water <br />' Start purge - 3 Sampling time <br /> Time Temperature E C PH Turbidity Volume <br />' - 3 . & 10 2 _ 6 <br /> i <br />' F 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 9/16 Bolt <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks <br /> i <br /> i <br /> Signature <br /> 1 <br />