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SAMPLING INFORMATION SHEET <br /> Client -Ramage Environmental Sampling Date <br />' . Site 222 East Weber Street Project No <br /> Stockton Well Designation I <br /> is seta of traffic control devices re uired9 YES time hours <br /> p 9 <br /> Is there standing water in the well boxy Above TQC Below TOC <br /> Is top of casing cut lever 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"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 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 0 16- 065 147 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time Time Calculated purge <br /> Depth of well Depth to water Actual purge <br /> Depth to water <br /> t <br /> Start purge Z � Sampling time 2 . <br /> Time Tem eratui e EC H Turbidit Volume <br /> Z. z l :3I <br /> i <br />' Lock IV4 <br /> Sample appearance � _ <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 /> M <br /> Signature '� <br />