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i r <br /> .ATION NO.: Ded /-. vt$ WELL ID: <br /> CATION NAME: SAMPLE ID: <br /> COUNTY: eZ" vt DATE PURGED: <br /> DISTRICT: DATE SAMPLED: <br /> WELL INFORMAI�LON.--Gallons per linear fi for casing diameter of 0.75"-0.023 2" 0.163 -0"-0.6S3 <br /> Casing diameter(in)f� J• Depth to liquid(ft): Well depth(ft):_. screened interval(ft): <br /> Wetted screened length(ft): Static liquid level should remain above-(ft): . <br /> WELL PURGING: Start Time(2400 Ift End Time(24Qp __ ,rump rate: (liters/min) <br /> ES-submersible Grundfos-submersible _ Peristaltic Teflon bailer PVC bailer <br /> Depth to,intake from TOC t±R):. . <br /> volume pur$ taii) Purge water disposal:Contain d' a in plastic(steel drum <br /> Time Volume DTW Temp pH HC -DO ORP Comments <br /> e Hr) �(rsrira,✓ f R; (�G•j .(std.units) (AS62510 � (i�l) (m 0-e-calor/odor) <br /> •� <br /> pro* I. p ►� <br /> fs:od S674 A <br /> 3: t0 f S d <br /> 13 f 3o sl. Zd <br /> f 3 J~ . d <br /> -WELL SAMPLING: Start Time(2400 Hr): " End Time(2400 Hr): , <br /> Equipment used Peristaltic = Givndfos _ —, Teflon bailer PVC bailer Dedicated <br /> QC samples.col ctcd it yveli: _ "' 1 _. S les filtered 0irough 0.45p.m <br /> il�ifl/lltiltli^�•. `, � �'- rF a �—il--•' • __— ..� � /7 I F.YI� •/'.- r-� f! '•� �.� •� � <br /> '"peter Calibration: Date: Time: Location of calibration: <br /> ( )pH 4: /�.�pH 7:(_—____ /��D.O. <br /> Reviewed by- <br /> Signature:`.1 /, Page _ _of rt. <br />