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GRGUNCWA7ER SAMPLING FORM <br /> PRQJE 7 INFECRMAT1CN, i <br /> JFPRCJECTNAME US 4 # 110 PRCJE-:T NUMEER I! . G`i'g-S,'� WELL NO I <br /> PRCJECT MANAGER Vii{ 'i YPE OF WELL. Monitoring Extrac:lan Otter <br /> RECORDED RY_ }' IL. f't c _ SAMPLED BY _ AA q, A DATE &_uy�_ I <br /> I <br /> WELL. PURSNG INFORMATION, <br /> PURGE VOLUME PURGE METHOQ I <br /> Well Casing Clameter <br /> _?-roan 4nc:t Other k Bader - Type <br /> Weil l"atal Ceptft `� 7 L feet below Tap of Casing,TO Pump - Type <br /> � I Cider - Specify <br /> Ceattt to Water � / feet below Top of Casing,WL Hydrocarbon Colors <br /> Water Column Length feet Yes No <br /> Purge Volume Calculation (Water Cai=n Length x Multiplier x No Velumes = Calcllated Purge Volume) <br /> • X j2,t(, X 4 3 = Calculated Purge Volume°= ens <br /> (WCL) (Mutdcaer) (No Vaiumes) Actual Purge Vaturne = Ions <br /> M Motler iICas;rasM=eterNdI sl -<Gailonsibearfccd 4=U6 6-i"5. 3—Z <br /> Grourimmter Parameter Measuremem Meter Type4G- Calibrated Yes,Na <br /> TIME �51_ApSEO � FLCWRA7E 07W pN EC I TEMP TURBIDITY r�ECQX COMMENTSi IME (GPM) (it) anhos�om dog c (N Nl mV <br /> 072s 1 0.7241 1 1 ZZ <br /> ! I I I I <br /> I I <br /> I I I ! <br /> 1 I I <br /> I ! I <br /> 1 I I i I <br /> f I I 1 ! <br /> I <br /> I 1 I I I <br /> 1 I I i <br /> I ! I <br /> I I t <br /> 9MR4 <br /> x A GEa7ECliN F 1�+`INC. <br />