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ENGINEERING, INC <br /> RCI=#27011 LIC#537901 <br /> 8084 Old Aubum Ad.Soda E Citrus Heights CA 95610 <br /> WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> Project Name Job* Well <br /> Date <br /> _Sample ID <br /> Sampling Team <br /> Purpose of Sampling ''i Initial >_;a'Ouarterfy ❑ VenficabonI—J Other <br /> Weather CondiWns <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> Description Tme==(TOCeto GW)—Total Depth= Feet of Water— C Factoron volng <br /> 1_ <br /> (ft to gals) ( aliansi <br /> Initial �'� � g'� �(p5 <br /> After Development/ [r rY �r C I <br /> Purr l b <br /> At Time of12 �� ( Three Casing Volumes C] Gals <br /> m <br /> Salin Ten Casing Volumes Gals <br /> WELL DEVELOPMENT/PURGING r <br /> Equipment +Submersible Pump ❑ Marler C Sandpiper LJ Other <br /> Method ' 2'�r T1 <br /> {ter nPoan <br /> DecontamirtaUon Method <br /> Liescription 40 <br /> Water Containment rums E) Baker Tank ❑Treatment System �� Other <br /> Labeled <br /> 1;T('D)JY <br /> Tempe lure Observations <br /> °F C (umhos} pH <br /> (Color,Turb+Uty,Oils Odor) <br /> LDA D 32 A t <br /> I j <br /> SAMPLE INFORMATION <br /> Lab <br /> Sampling Containers/No of Containers Preservation <br /> 1 Liter Amber <br /> 40 ml VCA _ _ — Ice - Other_ <br /> `tai- -� - - - ---- <br /> - Other iCe - - >_'� Other iY <br /> Ica _ Other <br /> Ce`nce >---sailer Disposable ` Other <br /> Perureni Field Observabons <br /> r <br /> Devoabons From Standard Sampling Protocol <br /> - - r <br />