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Site Address ��+� �- ,<�►ao��e Site NumberC <br /> "Ds,will t1 Protect No _ ae72-—j -z 6,-4Y • <br /> Project Manager Project PM <br /> Site Conlacl&Plwne Number Site Sampled By Dale Sampled 1 •�/�{ <br /> Water Leve] Data Pur a VOIUMe Calculations S implllllg Analytes Sample Record <br /> Top of Total Casing Three Actual Other <br /> Depth to screen Depth of Clteck if Water Well Multiplier Casing Water BTEX -I PI i-g M f a _� — Dissolved Sample <br /> Waley Interval Well Purge Not Column Diameter Value Volumes Purged (0020) (0015M) (,13020) ______ Oxygen Fregency Sample Sample <br /> Well ID Time (feel) (feet) (feel) Required (A) (inches) (13) (gallons) (gallons) VOA VOA VOA _ _ (mg/L) (A,S,Q) I D l line <br /> c7 CI •�i z �� _ ❑ ❑ ❑ ❑ v D <br /> ❑ ❑ ^ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ _❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> U ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> Cf ❑ ❑ ❑ ❑ <br /> ❑ - ❑ - ❑ u ❑ <br /> ❑ ❑ ❑ Q ❑ <br /> ❑ ❑ ❑ 11 ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ _ ❑ - ❑ ❑ 1 ❑ <br /> ❑ ❑ ❑ ❑ LEI <br /> (A)Gasmg Water Column Depth to Oullom Deplh to Water (q)MuMpher Values (2"Well 0 G) (A Well 2 0) (6"Well A 4) sampling Sequence Annual <br /> quarterly <br /> Sampling Notes Lrsl depili or Sample on C O C 11 e MW l 3U Make Sure to No(e on C O C Provide 1-mes(Reporling Lnral Available" Ongmal CVples of field Sarnphng 5heels are Located lit nrolecl Fite <br /> 1f Bre water level is below[lie lop of the sr reen,take a grab sample and check box for No PURGE(NF) If(he wafer level is above(Ila Screen,purge as normal <br /> ILA( Blank Santphng Sheets XLS) (Page 1 of 2) Last Primed 1112!01 <br />