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AP <br /> GROUNDWATER SAMPLE COLLECTION DATA FORM <br /> SAMPLE I D. NO : 1)7UJ- 6-,q WELL NUMBER. — <br /> DATE/TIME: WEATHER. f1l,-4i W4�r� <br /> ANALYSIS. ,-r �4r r/ /0 <br /> WELL PURGING DATA FILTERED? Yes Q <br /> Initial depth to water. _q 525" Filter Device: In-line <br /> Depth of well: Filter barrel <br /> Volume of water in well: Lab <br /> Date/time at start of purging: IV._!3 Otber <br /> Method of purging: Lig, I e r <br /> Method of Decontaminating <br /> purging equipment: <br /> WATER QUALITY OBSERVATIONS DURING PURGING: <br /> Volume Depth to <br /> Date/time purged water Tem . ,OF pH EC Umhos <br /> d /141 ro,. t 1} o,4er <br /> Y <br /> r <br /> 3 <br /> r Z o <br /> SAMPLE CONTAINER DATA SAMPLE METHOD: <br /> Number/type of container. aril <br /> r <br /> Z VOA capacity: c40 <br /> preserve: fie _ A^VG <br /> Amber capacity: 9 <br /> preserve: . <br /> Plastic capacity: 4-- <br /> preserve: il &0- <br /> Other (describe): <br /> SAMPLE PRESERYA N OD: <br /> Iced Other (describe): <br /> Signature: Dateflme: -3- S' O <br />�' pmealon Mmah L991 <br />