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PUrp e Loi Form <br /> Project 1�ar,�e ��)s� Project Number `I <br /> Sire Location Qfic,-L. <br /> Well No S Dat e.�F 11.E 1 a <br /> Field Tecli A j <br /> Total Depth Depth to water / y 6 ft <br /> Wat:r CoIur,n Length f --3S <br /> Casing Dianeter`7-- Casing Factor I r r <br /> Volume Calculation <br /> Total Pure Volume CasL�ovolumeA <br /> s Produced 3, Pur Type}P e C�111 <br /> PH Meter ,Qk-hy rated Cond Meter <br /> Calibrated &or N <br /> Temp MeterUte^ Turbidity Meter <br /> Calibrated Y or N <br /> [Cassg Factor. 2"- 17 3"=,g 4"= 66 5"--102 6"=] 5 8"=2 6 (In Gallons per ILnesr foot)J <br /> T-me Prod Rate Gatlors(total) DTW Ph <br /> Ec Te.m,a(°C} T u-oiciry ComL-nezfs <br /> LI <br /> / Ue - <br /> / /L4 <br /> . 1 S 1 A4 <br /> U � � 3j If 1 �jI <br /> � U <br /> S,orzee or Disposal ivIethod �rfj <br /> Total Drums Ors,te <br /> P-'cezt Recharze Prior to Samplirs i f <br /> _ jaes, <br /> Sample Collection Method <br /> Scinole Labeled {,.J �.� k/ ' S <br /> Sample Tine- lZ3p Labo,ato.y — <br /> .1-.a <br /> No of Containers <br /> Duolicat= <br /> Trip Blare Rrrsc`:Blain <br />