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pjerk, y <br /> n <br /> Corporation J <br /> WELL,DEVELOPMENTISAMPLING DOCUMENTATION FORM <br /> Project Name <br /> Job# .. ~ 44- - # <br /> Date -`• �. <br /> Sampling Team <br /> (Names/Responsibilities) r ; <br /> Purpose of Sampiing s Initial Quarterly Verfication Other <br /> Weather Conditions <br /> GROUNDWATER LEVEUCASING VOLUME mP M v <br /> _ <br /> Depth •Total s Feet of Conversion Casin "Volume <br /> Time TOC to GW Depth, Water Factor Gallons <br /> —Initial LA <br /> _After develop/purging 7 <br /> At time ofSampling Three Casing Volumes Q Gals <br /> Ten Casing Volumes Gals <br /> f 4 <br /> WELL DEVELOPMENT/PURGING <br /> Equipment: Swab-Aire Sub PumpL_,L. Bailer Sandpiper Other: <br /> Method Description: �� 4 I <br /> Decontamination Method: <br /> Water Containment: rums baker tank other: <br /> *Labeled: <br /> r °" <br /> Pump Vol.Water Temp. EC _ <br /> Observations.- <br /> — Time :Rate Extracted FIC umhos H calor,turbidi oils,odor + ► <br /> Start 2 <br /> co, 2 <br /> Lab: <br /> SAMPLE INFORMATION <br /> t� <br /> Sampling Containers/Number of Containers/Analysis Preservation Description <br /> 1 LiterAmber a - Ice 'and `� °" ' • r ._ _ `-, <br /> 40 rrll Vo and <br /> ,. '.Other <br /> ce and <br /> k <br /> Time: - I <br /> Device: Disposable Bailer✓ ..Other: --' <br /> Pertinent Field Observati _110 <br /> ons: a �. . <br /> Deviations from Standard Sampling Protocol: f. <br /> ,. - <br />