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� • n <br /> / <br /> Ni�k <br /> Corporation <br /> WELL DEVELOPMENTISAMPLING DOCUMENTATION FORM <br /> Protect Nam <br /> .fob# �--71 <br /> Date 1 <br /> Samplingeam <br /> ' (Names/Responsibilities) <br /> Purpose of Sampling Initial Quarterly Verfication Other <br /> Weather Conditions <br /> GROUNDWATER LEVELICASING VOLUME <br /> Depth Tota! Feet of Conversion Casing Volume <br /> Time TOC to GW Depth Water Factor Gallons <br /> Initial 9 <br /> Atter deveioplour ing n (� l <br /> At time of Sampling 41+0 1 Three Casing Volumes 21:4 Gals <br /> ' Ten Casing Volumes Gals <br /> WELL DEVELOPMENT/PURGING <br /> leguipment Swab-Aire IBailer Sandpcper Other <br /> ethad Descnptson <br /> Decontamination Method --Tlb-P �c _•_ -- <br /> Water Containment drums baker tank other- <br /> Labeled <br /> therlabeled <br /> Pump Vol Water -T.emD Observations <br /> Time Rate Extracted FIC umhos) cH (color turbidrty osis odor <br /> Start 0 II <br /> �l <br /> 2�- <br /> Lab I 5 2 <br /> SAMPLE INFORMATION <br /> �'�.,C� <br /> I <br /> I <br /> Sampling Containers/Number of Contairters/Analysis PreSerVatiun DG;CriptcUrl - <br /> 1 Liter Amber Ice and <br /> 40 ml Voa = Ice and <br /> ' Other Ice and <br /> Time <br /> Device Disposable Bailer Other <br /> Pertinent Field Observations <br /> Deviations from Standard Sampling Protocol <br />