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WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> Project Name: Job# `.76 Well# <br /> Dates: Samples ID:------------------ <br /> ling Team: r a. <br /> Purpose of Sampling: ❑ Initial l_ Quarterly IJ Verification Other: <br /> Weather Conditions,- Jr[JrJ n ti <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> Conversion Casing <br /> Description Time Depth Total Depth Feet of Water Factor Volume <br /> TOC to GW ft. to als. allons <br /> initial d cy• ) -;-lb �l <br /> After development[ 1� ' <br /> Purging—_ II�� ss- <br /> At <br /> At Time of Three Casing Volumes 3-S� Gals <br /> Sampling lj Ten Casing Volumes Gals <br /> WELL DEVELOPMENT/PURGING <br /> Equipment: Submerisible Pump ❑ Bailer ❑ Sandpiper ' Other: <br /> Method: a If + -x,10 W <br /> Description <br /> Decontamination Method: 73r IFi <br /> Description <br /> Water Containment: Y,Drums © Baker Tank a Treatment System 17 Other: <br /> 9 ed: <br /> Start Time Volume Water Temperature EC pH Observation <br /> Extracted °FI°C mV Color,Turbitity,Oils,Odor <br /> ��a � • � Via- � . S •31, <br /> 3 3•� a . o I .L{ I <br /> SAMPLE INFORMATION 50r1.5�i9-aG <br /> Sampling Containers/No.of Containers Preservation <br /> 0 1 Liter Amber ❑ Ice 0 Other <br /> J6c_40 ml VOA_ D Ice 0 Other <br /> 0 Other ❑ Ice 0 Other <br /> Device:. i$-Bailer, Disposable Il Other <br /> Pertinent Observations: <br /> Deviations From Standard Sampling Protocol: <br /> GHH ENGINEERING INC. <br /> 11960 Heritage Oak Place, Suite 29,Auburn,CA. 95603 (530) 886-3100 <br />