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70.. <br /> WATER SAMPLE FIELD DATA SHEEi _ Rev. v92 <br /> �90JECT NO l -1 ") �- "^ �. �.`� - - SSAMPLE ID - � �rlCO =URGED BY 1'�It �t CLIENT NAME 7 fZ2 <br /> SAMPLED BY s <br /> LOCATION <br /> TvoE Orouna Water <br /> Surface Water L eacnate Other <br /> C—SING DIAMETER (Incnes) ? 1 <br /> 5 a Other <br /> ZASING ELEVATION (feet/MSL) VOLUME IN CASING gal <br /> DEPTH OF WELL (tees) ) <br /> CALCULATED PURGE ,gal ) Z-.QEPTN TO WATER (feet! �- ACTUAL PURGE VOL (gal ) <br /> DATE rPURGI=❑ �,^ Z <br /> End Purge <br /> SATE SAMPLE'? <br /> SamattnQ Time <br /> 'tE VOLUME pH E C T EMPEPATUAE <br /> (9at1-­00 Ho (units) -,nnasrrm(cD 25° C) TURBIDITY <br /> (°F) (+isuaucatialtl ( lsteai�NTtJ) <br /> !S l ,C�.- 77?.S <br /> SSD � L� <br /> �s <br /> :.THER �' '�� k-1 r <br /> 1 ^0011 <br /> (CCeALT 0 tot]) (N`0) <br /> = ELC OC SAMPLES COLLECTED AT THIS WE_L (r e Fe t X OUP t) <br /> P M <br /> BlaGder Pum SAMPLING ^-,r !j <br /> Bailer(Tenanalt 2'eladeJer Pump <br /> Pu <br /> Centrttugat mp aa,ler(Te}loerm) <br /> �� sailer(pvc) comb samwer Saler(SUk%l tsS4M) <br /> Submerstale Pump Bader(5ta,nless Steel) <br /> DoperSubmersoW punp <br /> 'PWellWizard^ OeClrat>� <br /> Well llWtzard1i° Oedk:xwo <br /> _.~er <br /> Other <br /> WELL INTEGRITY �z <br /> RE"ARKS !OCK # <br /> Pt = C -emo meter Calibration Oate •}� LL— / Time <br /> E Z �0 + :0 <br /> ' 'lleor Serial No <br /> .. <br /> - r� I � ;H 10 ria <br /> Te- erasure <br /> S =^attire � �'k. � 1 ��1 p <br /> evlewea$y Page of <br /> , l <br />