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1E Lu Lu <br /> ENGINEERING INC <br /> RCE#27011 L1c #537901 <br /> Old Auburn Rd Surte E Cdus Heights CA 95610 <br /> WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> foj'ect Name Job .aq Well # <br /> Date 4 Sample ID �- <br /> pling Team <br /> tmm <br /> ose of Sampling i Initial �E-Quarterty C Venficatson ❑ Other <br /> Weather Conditions <br /> GROUNDWATER LEVEL(CASING VOLUME <br /> p Time Depth Conversion Casa <br /> Description (TOC to GW) Total Depth Feet of Water Factor Volume <br /> (ft to als) (gallons) <br /> tnfttal �O <br /> After Development/ 10 f r _ r <br /> Pur L L(D (s CM <br /> (DoAt Time of O} Three Casing Volumes Gals <br /> Sam lin r Ten Casing Volumes Gals <br /> WELL DEVELOPMENTIPURGING <br /> Equipment Submersible Pump <br /> ❑ Sailer C Sandpiper LJ Other <br />�ethod T&A l -►-I.O <br /> �7Uescripbon <br /> Decontamination Method �5 1MZF— <br /> escnpuon <br /> h1containment f?O Drums ❑ Baker Tank ❑Treatment System _ Other <br /> Labeled <br /> itat Time Volume Water Tem re -�fc Observations <br /> Extracted •F C {umhos) pH <br /> h (Color Turbdrty Ods,Odor) <br /> LOL <br /> ( 0 '-ft7 I <br /> L <br /> I <br /> I <br /> SAMPLE INFORMATION <br /> Sampling Contwners/No of Containers Preservation <br /> 1 Uter Amber Ice _ Other <br /> 40 ml VOA �- -{- <br /> Other - _ 'Ice Other <br /> _ Ica _ Otizer <br /> e �8ader Disposabfe _ Other <br />�o nent Feld Observatnons <br /> s From Standard Sampling Protocol <br /> R <br />