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�1 WATER SAMPLE FIELD DATA SHEET Rev. 1192 <br /> PROJECT NO I -9 C� <br /> �' ( SAMPLE ID <br /> EMCON PURGED EY " F <br /> .TIENT NAME � r I Ur r, <br /> SAMPLED BY {� LOCAI[ONT <br /> T, �E ur0tlnCJ Water Surface Water Leacnate <br /> Other <br /> CSS+NG uIAMEI`;=R (tncnes) ? 3 <br /> 5 S Other <br /> —SING ELEVATION (feet/MSL) � <br /> r��T VOLUME IN CASING <br /> DEPTH OF WELL (feet) `1 .� CALCULATED PURGE r7 <br /> DEPTH TO WATER (feet) 1 7— -1� yaf ) <br /> ACTUAL PURGE VOL (gal ) 7 S <br /> TATE PURGED % <br /> end Purge <br /> ,ATE SAMPLED <br /> Samolrnp Time <br /> - 1 1E VOLUME PH E C <br /> yEMpE(RA) TUE.00 Hrl units) LOR TURBIDITY <br /> 25• C} <br /> (v�5.tlaLcabalt) (vittualtNTU <br /> 1-7 <br /> fit <br /> S -r <br /> S THER � � � �� ' DOOR ' <br /> {COC'ALT 0 1001 tNj1j0-200) <br /> _ ;LD aC SAMPLES COLLECTED AT THIS WELL (l a Fe 1 X [)Up 1) _— <br /> PURQ,1tjG aQUEmfUl <br /> zt t3ladder Pump Fit <br /> Tatler(Tefl0nQ9) <br /> ='Bladder Pump r Bailer(Tefionel <br /> Centrtfugai Pump Hailer(PVC) <br /> womb Samprer Baste 4Stalnlns St'") <br /> 5u6merst0le Pump Batter(Stainless Steel) � <br /> .�vper <br /> 'Nell Wi2arSubnlemi3je Pump <br /> dTM ���� <br /> .. ~er <br /> :�stt wizardry Dedicated <br /> Other <br /> WELL INTEGRITY <br /> PE'tARiCS 1 LOCK# <br /> Ar == 'erne Meter Catibrabon Date n - <br />. <br /> E Time Mew Serial N0 <br /> = 000 �H 7 , rH 10 .y d <br /> Te^sera e � F ;~ <br /> r <br /> S z-atum 11 <br /> +Revtewea By Page - of <br />