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GROUNDWA TER SAMPLING F ORM <br /> Park WELL PURGING SHEET <br /> E nvt ronme n t at 41 <br /> In Aj A L_ecx7 cfMf�f+11Mi[ <br /> ITENAME:�,6 vs,4 Alia PUMP <br /> E ID #: JGV7 J3 Double Diaphram ❑ <br /> LL ID #: M W-3-P Bennet ❑ <br /> -Tiydrogeologist•" Grundfos 4" X <br /> ate DeveIoped•A"I3011gq i� Hand Bailed ❑ <br /> asing Diameter 21 <br /> 1 <br /> 30, 1 61t Other <br /> of H20/ft .17 38 .66 1 <br /> BAILER <br /> �eptb to Water _72 -01 /Measuring Point `ra- Disposable/�f <br /> Depth of Well /Height of Water Column Other <br /> X g <br /> (Height of Hz0 in Well) (Volume of Casing) (Well Volumes to be Removed) (Volume of Water to be <br /> Purged) <br /> -'Ti <br /> ^s c � ,i" r - <br /> �Tinitr�� �VoI of H 0� a � H �� ��'� �5"ecifc.� _ �ri, ��_ Sand ,;,"� �r _ �`� '� <br /> t, � z ;; p �.��- p .. Temp � � , ���T:. Other Comment`s�.�` <br /> "°RGInoYed r": '���`� �t 4'x �'� ' :�- t Q � w :y '• t�C` i+.., i <br /> �•,� _ x _y1Conductance F -Content ;> �(clarityrt"odor eolorotlier) <br /> �'' fa"�,�_- y< <br /> 0 - <br /> �, @'25,C� <br /> °�a.,4 f��xct.ar N-:-� ♦°" .,wY'` L !'`q� � .sY&"`d <br /> a.V s <br /> 5q`vt. $.[ �� ��•° lU � 1--,yah �a F�� <br /> 7 5r c.kar +?1_ l u" <br /> �0CA,11� (A�- �b <br /> I <br /> g..ws-w.��Y. -x..'.• t-K:.c "^. a ave_ ��.$¢ <br /> SAINIPLING METHOD ❑ Same as above <br /> ❑ Bailer- Type. s.s. ❑ Grab -Type: <br /> ❑ Submersible ❑ Centnfugal ❑ Bladder; Pump No.. ❑ Other-Type: <br /> SAMPLE% DISTRIBUTION Sample Series: <br /> Sample No Volnme/Cont. Analysis Requested Preservatives Lab Comments <br /> 1 3015 � �tee,[ Nark �►tu�'u, <br /> plcAC' 74Zs Led6 t4ND Sl <br /> 4231 Pacific Street♦ Suite 7♦ Rocklin,California 95677 <br />