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' SAMPLING INFORMATION SHEET <br /> Client Ramage Environmental Sampling Date - V <br /> Site 222 East Weber Street Project No <br /> Stockton Well Designation <br /> ti <br /> fr <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well boxy YO Above TOC Below TOC <br />' Is top of casing cut level? NO 6&M 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"CN1 36"CNI 12"Porneco 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 �e_ Teflon bailer Disposable Tubing <br />' Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 4 16 065 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time ` p4& Time :z? Calculated purge <br /> Depth of well Depth to water Actual purge _ <br /> Depth to water / <br /> 1 Start purge 1 Sampling time #2 <br />' Time Tetn er ture E C PH Turbidity Volume <br /> / .39 Z X03 <br /> 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 />' Signature <br />