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I <br /> Site Address. z yrl7O ivt L,ax Site Number: <br /> Project No.: O,( <br /> Project Manager: Project PM: • <br /> Site Contact&Phone Number: Site Sampled By: NlLV Date Sampled:. <br /> Water Level Data Purge Volume CalCUlatiofls Sainplin Ana! tes Sample Record <br /> Top of Tolai Casing TI wee Actual Other <br /> I Depilt to Screen Depth of Check if Water Well MuMpller Casing Water BTE=X "fPH-g MTBE _ Dissolved Sample <br /> Water ln(erval Well Purge Not Column Diameter Value Volumes Purged (11020) (i3015M) (€3020) Oxygen Freciency Sample Sample <br /> Well ID Time (feel) (feet) (feet) Required (A) (Inches) (B) (gallons) (gallons) VOA VOA VOA <br /> ------ (mglL) {A,S,Q} I.D. Time <br /> i 3.Z o ❑ 1g z Q ❑ _ ❑ ❑ ❑ <br /> w� ❑ 17.nG z ❑ IJ El El b' 7 Inh z ntl3 <br /> v7 Z.7'( ❑ ❑ ❑ w 3 <br /> m> if ❑W ❑ EJ _❑ ❑ �nw 4 d <br /> L 3r$ �-( El _� Z .y ✓�^5 ❑ ❑ ❑ ❑ IR-1 ods <br /> Z ❑ :� z ..—S" _z__ ❑ ❑ ❑ ❑ M z fob. <br /> ynw� b� —� <br /> t ❑— - `S ' -- ❑ ❑ ❑ ❑ 2�3 m a7Z7 <br /> ❑ y vv z _ 3 3 El ❑ _❑ [1- boja 7 <br /> 0 El EJ 0 <br /> Z 007, <br /> ❑ IQ El El_ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ Cl ❑. <br /> ❑ ❑ Cf [71 ElEl ❑ 1 ❑ El <br /> 11 ❑ El <br /> ❑ ❑ U ❑ ❑ <br /> ❑ ❑ u ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> (A)-Casing Waler Celurmr: Depth to noltorn-Deplh to Waler (f3)-Mluttiplfer Values: (2'Welf:0.5) (4"Well:2.0) (G"Well:4.4) Sampliuy Sequence: Alinual: <br /> Quarterly: <br /> 3 Sampling Notes: List depth of Saila ple oil C.O.C.11,e.MVV-1(30)1. Make Sure la Note olr C.O.C.'Provide Lowest Reputting Limit Available." Ori incl Copies of Field Sam lira Sheets are Located in Project File <br /> If the water level is below the lop of the screen,fake a grab samlA and check box for NO PURGE(NP). ff the water level is above the Screen,purge as normal. <br /> i, <br /> 'I LA(, -Blank Sampling Shee(s.XLS) (Page 1 of 2) <br /> Last Printed: 1112101 <br />