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�s Site Address Site Number GQ40 <br /> 211f0 <br /> City Protect No <br /> ,r r Sampled By 13g" Protect PM <br /> Date Sampled 12 tol <br /> Site Contact Phone No <br /> Water Level Data Purge Volume Calculations Well Purge Method Sample Record Field <br /> Total Casing Three Actual DTW Data <br /> Depth to Top of Depth of Water Well Multiplier Casing Water At Dissolved <br /> water Screen Well Column Diameter Value Volumes Purged No Sample Sample Sample Oxygen <br /> Well ID Time feel feet feet (A) (inches) (8) (gallons) (gallons) Purge Bailer Pump Other Time I D Time —LL/L <br /> I V- `t Y0 f7 -11-03 2 3� o 4"t olfg 140.11 IS-61 (ri L <br /> .14R g1-40 20 20 3 a <br /> Alit 'cr. tS C 7 11 t t 6-1 <br /> f, 0111 yr.rf d 7.3 41 1 1'7 r OL3t <br /> 4 pny g I — r, <br /> 7 t1i S t 1117 oz, 1t7 to z0 <br /> o 003 Y1.o 7tU n30 4 <br /> 1.431 Etr. 3Z f Z11.0 of <br /> • 4Ati 4(.31 534 <br /> �b <br /> (A)Casing water Column Multiplier Values <br /> Depth wtr Depth to Bottom 2"=0 5 4"=2 0 6"=4 4 Page 1 of 2 <br />