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i <br /> SAMPLING INFORMATION FORM <br /> JOB NAME San Joaquin Cemetery SAMPLE ID# c,/Z /0.09S� <br /> JOB NUMBER 76321 WELL NUMBER _ 4�4,4/ <br /> WELL INTEGRITY Locked °C Unlocked General Description _rzo o <br /> PURGE CALCULATIONS DATE TIME INITIALS <br /> MEASURED WELL DEPTH ( 7,C -72 )FT ZQ <br /> MEASURED WATER LEVEL DEPTH (r7, )FT <br /> STATIC WATER HEIGHT ( )FT <br /> CASED WELL VOLUME=STATIC WATER HEIGHT x 0 65 gpf <br /> ( T./j� ) = ( Q, S`/ ) x 065gpf <br /> REQUIRED PURGE VOLUME=(CASED WELL VOLUME x 3)+(FILTERPACK") <br /> ( 9. `/f ) = ( 3, /j x3 ) + ( A ,4 ) DZo <br /> ACTUAL PURGE VOLUME=( J 0, ,90)gal START <br /> PURGED DRY STOP -TO-93- i lo -lo i CA I <br /> **Fllterpack Calculation If Static Water Height(SWH) is<20ft, multiply SWH by 2, or if SWH Is X20 ft add 40 gal <br /> NAME METHODo Packer Inflation (PD-WL) x .433 + 30 = <br /> ❑ PUMP ❑ SUBMERSIBLE ❑ BLADDER =PNEUMATIC ❑ PERISTALTIC <br /> cR� BAILER ❑ PVC i�g TEFLON ❑ STAINLESS <br /> DESCRIPTION OF PURGE WATER o D ocf4 ,? <br /> (INCLUDE COLOR, ODOR, ETC ) <br /> WEATHER -5-1. y 7S <br /> (INCLUDE TEMP , GENEITIONS) <br /> PURGE MEASUREMENTS --F <br /> TEMP ( C) pH (S U ) CONDUCTIVITY(umhoslcm) ITURBIDITY(NTU I DATE TIME INITIALS <br /> A(9 7LO Z <br /> 19,9 7, 9 TN <br /> I Ile <br /> COMMENTS `� <br /> ` 0 65 is used for 4-inch diameter well casing SIF XLS <br />