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Air <br /> WATER SAMPLE FIELD DATA SHED' Rev. 1192 <br /> =90JECT NO I 1 <br /> SAMPLE i0 f-- <br /> ENICcN =URGED BY r, 1 <br /> �Sr LIENT NAME <br /> SAMPLED BY LOCATION <br /> r'c)E Ground water Surface Water Leacnate Other <br /> C—S,NG CIAME i E 7 (rncnesl 3 4 1 5 <br /> � Other <br /> CASING ELE 'ATION (1eeVMSL) VOLUME IN CASING r' <br /> OEPTu OF WELL (feet) 4-2 Lj CALCULATED PURGE ,gal ) C� <br /> DEPTH TO WATER (feet) 1- ACTUAL PURGE VOL fgaf ) <br /> SATE PUPGEtG ' Z a 5 End Purge <br /> -ATE SAMPLED 1 Samoting I lme j ( <br /> '1E JOLUME PH c C TEMPERATURE <br /> .00 Ho (gal 1 fu (lunn0srcmcaD 25• Cl F fw =OLOR TURBIQITY <br /> L.� (' } suai/meaitl (vls+rslrNTU) <br /> A 141 <br /> Z1HER ODOR r1l <br /> ` (COOBBALT 0 100) (N?U 0�_20dy-Z00} <br /> = ELD OC S:-MPLES COLLECTED AT THIS WELL 6 e F9-1 X DUP t l / <br /> QURGING EQUIPMENT <br /> ?'gladder Pump Sailer(Tellonol 2'Bladder Pump Sailer r TeAon®) <br /> Centnhicat Pump _ sailer(PVC) <br /> Bomb Sampler Sailer rStalrtlfta SIpW) <br /> Submersicie Pump Bailer(Stainless Steel) Dipper <br /> Su6meratsaie pump <br /> NON wizardr" Dedicated Well wizarafm <br /> -�er Dedicated <br /> Other <br /> WELL INTEGRITYL. , n �, <br /> LOCK .{? <br /> R E'I A R K S 1S" 4 05U I ' <br /> Pt4 =C -emc Meter Caiibrauon Oate 1,L) <br />• B _ :.�0 -�� ;, Tim4 'Tatler Serval No <br /> H 7 pH 10 rH n <br /> Te^aeran/irprjF _ / I <br /> f <br /> S ="atUr6. u717 r <br /> Pevtewea 8y Page _ of <br />