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GROUNDWATER SAMPLE COLLECTION DATA FORM <br /> SAMPLE M NO- Iq w — 3 <br /> WEL NUMBER M W -- 3 <br /> DA-ErrDAF. r z f Z l 3 1s <br /> WELL PURGING DATA <br /> NrnAL DEPTH TO WATER S. Z <br /> DEPni0Fwriz /If./9" �. �z x ,f6� x 3 = �• 34. <br /> vaUMEOFwAj RINwE L 2•Z? <br /> DATE/TIMEATSTARTOFPLq=sr, /Z/Y I'Z / 3 <br /> MEi mCFP[ntC m D"s a 5G � le l34 '�er <br /> METHOD OF DECONTAMINATING PURGING EQUIPMENT. <br /> WATER QUALITY OBSERVATIONS DURING PURGING. <br /> VOLUME DEPTH 'TEMP EC <br /> DATE PURGID OF j� [� A)otes <br /> fZ I3 z7 2 -� 6 /,9 6.9 211/1x16 <br /> It 1331 y . 6z.y` 6 .67 z-16xro3 « <br /> 33 7 7" 9.4.S J,7�j <br /> SAMPLE CONTAINER DATA <br /> NUMBER/'TYPE OF CONTAINER: <br /> 2 VOA-CAPACCIY: y0 <br /> -FRESERV: �t <br /> AMBER-CAPAC y: <br /> -FRESEKV: me <br /> PLASTIC-CAPACITY: <br /> -PRESERV. <br /> OIfIE•1t DE SC RISE. <br /> SAMPLE PRESERVATION METHOD. <br /> - _ KED <br /> (� <br /> OTR-DFSCRIBM <br /> 9CNATU M <br /> hJ <br /> DA'IEr1E I Z 191 'Z— ! 3 <br />