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b 7 r <br /> b Srle Address 7ft V, jo VANIA1 site Number <br /> Ptolocl No <br /> Sllo Contact&Pllune Number _ Sile Sampled 13y " �d Udle balrlpled <br /> Wn[er Love[ [Ja[a --� ['utye VOILH110 CdICLIWIUr)S j Satltryllltlj Aiia[y[os Sample Record <br /> 1ppof lolal Casing rllree Actual Other <br /> Depth to Sor een Deplh of Check rr Water Well MulOpller CdSIIH] Water a rCX I I'I l g M rDL Dissolved Sample. <br /> Wale; lnteival Welt Purgo Not Colurun []lanleler Value VOILIMeS Purged (€5020) (0015M) (11020) Oxygen Fiegency SamlAe Somplo <br /> We11 ID Tirrre (feel) (reel) (reel} 8131.1 lrfld (A) (Inches) (ll) (gallons) (gallons) VOA VOA VOA (tnglL) (A,S,Q) I D Irmo <br /> ,w X13 �1y y 1 7Z Q V-V �" L-1 El Cl El 1 <br /> w 3 -� 73 Ci ti`' ❑ ❑ _❑ ❑ �__ �•5 rn � a �� <br /> �1� - 0 ,��f K — _,� -V�— [-1 ❑ u ❑ � yy.�o � o <br /> y% " _ K x'33 0 7 �{ ❑ -_ ❑ �I-] u - 7 <br /> k 11601 <br /> 1 tkio OAP <br /> pw 7 _ ,z ❑ 211• z I'f t ❑ ❑ c� ❑ 3. 04.7 <br /> ❑ _ ❑ _ C[ _Cl_ Cl <br /> Ll- ❑ ❑ ❑ ❑ <br /> CI ❑ ❑ 0 CI <br /> Q ❑ L _❑ ❑ <br /> ❑ _ ❑ ❑ ❑� ❑ <br /> ❑ _ ❑ CI 1=J Cl <br /> L ❑ Cl ID �[ <br /> Cl LJ CI ❑ ❑ <br /> ❑ ❑ ❑ CJ CI <br /> ❑ ❑ ❑ <br /> (A)Canbu Water Cuhnnro Uep(ri to oullum oeplh iu Waler (11)Mulllpller Vatues (2 Weil UG) (4"Wall 2 0) (G"Wet€ €,I) Z"f Samplhrp 5a(luence Annual <br /> I QUUi lady <br /> Lrst depth of Saumte qn C o C lie MW 1 A0 l Matte Sure to Nute on C O G I'ruvrde Lowesl Ile wt Ibrc Uiof Avulluble" Onyirral Cupic5 of Held Sampli"(1 Sheets are Lo�aled in Plofe�l r Ile <br /> Sarolpling Notes -- •, (�._._ _ <br /> lithe waler Wei is below ltle top of the screen,lakes grab simple and t IDLI(I)OX for NO PURGE(Nil) If the walor level is above the screen,purge as numat <br /> I l_A( L]lank Sampfirrg Shepls XLS) (Paye 1 of 2) L.rst Prided 1112101 <br />