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Groundwater Sampling Form f <br /> Diilect Name Ce �T 'rp� Well No /NW^ ! b <br /> Project Number 12- 30V41.,01 Wetl Type Monitor ❑Extraction ❑Other <br /> Recorded By Sampled by -AF Date 12p! y <br /> WELL PURGING <br /> PURGE VOLUME <br /> PURGE METHOD <br /> Well casing djameter ❑Bail r-Type <br /> ❑ 2-+nch 4-rnch F]Other ump-Type r "N <br /> Well Total Depth(TD ft-below TOG) `{7 r ❑Other _ <br /> De=to Water L R below TOC LI O 2Z PUMP INTAKE <br /> De th to free Dhase hydrocarbons FP R below TOC N ar top Depth(R) <br /> Number of weq wlumes to tae pur ed f ear Bottom Depth(R) d/ 71 <br /> s ❑ 3 ❑ 10 Cher L4 Other <br /> PURGE VOLUME CALCULATION q 'd Pumping Rate 0?1 (c gpm <br /> Water Column Length MvlLplier No Vats CALCULATED PURGE VOLUME <br /> IMUL-nPLIER(r-asing Dm inches =GallonsRnear R / al <br /> 2=0 17P=03a 14=066 45=083 15- 102 16=15 18=26 ACTUAL PURGE VOLUME <br /> GROUNDWATER PARAMETERMEASUREMENT Meter Type <br /> TimelGallons pH Cond. Temp deg C Turbidity ColorlOdor <br /> uomhos/cm d F NTU <br /> f I <br /> IQ 3 '7 Sc� DO, S- cS <br /> I 1 !o .1 �/ 31$D 1 t (3 zF <br /> -3�1,00 al 1-7 f aefe <br /> a. ! '7 — 3S o 2A o [ -Ga a <br /> r 5 i t >1 2-oa F <br /> l <br /> ! <br /> Comments during well purge � 't IS <br /> Wert Pumped dry YES Purge water storage/disposal []Drummed onsitea0d)e`rrLP4.A,3Sfg,7 7-0 <br /> WELL SAMPLING / <br /> II SAMPLING METHOD Date/Tune Sampled /2_Q/9 4 I /ol) _ <br /> J Bailer-Type Er Sample port ❑ Other <br /> GROUNDWATER SAMPLE PARAMETER MEASUREMENTS Meter Type SOLrA)r57— S10,kto <br /> Dated-imel%Recharge pH Cond Temp eg C Turbidity Color/Odor <br /> uomhos/cm d F NTU <br /> 12-01942 $ l b opt <br /> ! SAMPLING PROGRAM <br /> Sample No I Container#/Volume Analysis Preservatives ILaboratory Gommenis <br /> � E <br /> 1 I <br /> ; c <br /> QUALITY CONTROL SAMPLES <br /> 1 <br /> Duplicate Samples Blank Samotes <br /> Onclinaf Sample No i Duplicate Sam le No Type Sample No <br /> Trip <br /> i i1 <br /> Rinsate <br /> Transfer <br /> Other <br /> i <br /> I <br />