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Site Address ih Ld Site Number <br /> r <br /> Project No <br /> Projecl Manager Pro)e(A PM �} <br /> Silo Contact 8 Ptnolle Number Site Sampled BY Dalo Sampled 2, 1f+(p Z <br /> Water Level Data Put a Voluilie Calullallons Salltl hoU Analytes Sample Record <br /> Tppof total Casing Three Actual 011ier ��� <br /> Displll to Screen Depth of Chock if Water Well Multlpller Casing Water La l CX 1 PI 1 g M 113E Dissolved ftR1�3![n <br /> Water Interval Well Pulge Nut Column Dlametel Value Volumes Pulged (0020) (0015M) (0020) Oxygen rlericy sample sample <br /> Well lD Tinne (lent) (foci) (feet) Required (A) (Int hes) (0) (gallons) (gallons) VOA VOA VOA _ _ (mglL) } 1 D luno <br /> -3p 7 _ ❑ 1je:6 2 _0, ❑ _ ❑ ❑ ❑ )9.6 2.+-ff7-Ny, a <br /> ❑ ❑ - ❑ -❑ ❑ <br /> ❑ _ ❑ ❑ -D ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ _ ❑ _❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ci ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ __ ❑ ❑ 0 ❑ <br /> I-1 ❑ ❑ ❑ ❑ <br /> ❑ ❑ _❑_ ❑ <br /> ❑ ❑ ❑ EJ ❑ <br /> ❑ ❑ L ❑ ❑ ❑ <br /> (A)C-slnu Water Culu11w Mph to 130110111-Depfh to Water (13),Multipliur Values (2'Well U 5) (A Well 2 U) (G"Well A 4) Sampling Sequence Alinual <br /> quallerly <br /> Sannpltrlyd Notes Usi de th ul Sample on C 0 C 11 e MW 1(Jo)l Make Sure to Note oil C 0 G Provide Lowest Reposting Lint Available" _ MI y1ial Copies of Field Sampling Sbeels are Located rrr Pmjer t File <br /> If Ilse water level is below the top of the ar reeu,take i grab sample and check box for NO f URGC(NP) If ilia water level is abuve ilia screen,purge as normal <br /> ILA( Mank Sainplhlu Sheets XLS) (Page 1 of 2) Last Printed 11-12101 <br />