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GRCUNDWA7ER SAMPLING FORM <br /> PFZOJEOT INFORMA71CDN I <br /> WECT NAME USA Gas ::Ay-r, PRCJE:. I NUMBER �5Y ?5?1Z X03 WELL NO � <br /> PROJECT MANAGER MA --TYFE OF WELL / MOnitonng Extraction Other <br /> RECORDED BY Af SAMPLED BY ow DATE <br /> E <br /> WELL RJRGING INFORMATION � <br /> PURGE VOLUME PURGE METHOD <br /> Weil C ng Diameter <br /> 2-Inch 4-Inch Other Sailer - Type <br /> Pump - Type 5vinui*silr� <br /> Weil Total Depth 0 fe--t below Top of Casing,TO Other - Sp=fy <br /> Depth to Water (�2"?e? feet below Top of Casing,WL Hydrocarbon Cdors <br />� Yes <br /> Water Column Lengthfeet <br /> Purge Volume Calculation (Water Column Length x multiplier x No Volumes = Calcuited Purge Volume) <br /> x 01 1 C, X 73 Calculated Purge Volume = r �� gallons <br /> (WCL) (MutIptier)— (Na Volumes) Actual Purge Volume = llans <br /> i4�oller ECasirn Diameter Uncheslfootle 2 Cr= tT 4=255 x S;7-1 S: 8!;L 2.5 ;y_ <br /> Groundwater Parameter Measurement: Meter Typejwl Calibrated <br /> TIME ELAPSED FL WRATE 07W pH EC TE%Ap TURS101 Y REDOX COMMENTS <br /> TIME (GRA (g) anhoslem (NTU7 I mV <br /> —deg F <br /> 4 I <br /> If= <br /> I I I <br /> I I <br /> i <br /> ASSOCIATS INC. <br /> FllmamugrrAL.GE-OTECH19CALAND NA7FRL41+PHaFFS20NAL-3 <br />