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GROUNDWATER SAMPLING FORM <br /> PROJECT 1NFQRMATiON <br /> OJECT TAME PROJECT NUMBER 63` 3- 'WELL NO 0 <br /> PROJECT MANAGER TYPE OF WELL_ Manitonng Extraction Other <br /> RECORDED BY ' _ SAMPLED BY DATE <br /> I <br /> WELL PURGING INFORMATION <br /> PURGE VOLUME PURGE METHOD <br /> Well C zng CEameter <br /> 2-inch 44nch Other ,:L'_/Bailer - Type ��f1 <br /> (1 <br /> Well Total Depth ' <br /> feet below Tap of Casing,TD Pump Type <br /> Other - Specify <br /> Depth to Water S- feet below Top of Casing,WL Hydrocarbon Odors <br /> Water Column Length Meet <br /> • Yes No <br /> Purge Volume Caiculabon (Water Column Length x Mulhplier x No Volumes = Calawated Purge Voturne) <br /> y 2 <br /> x G- 17 -7r at <br /> Calculated Purge Value = � � fans <br /> (WCL x 3 _) (Multipiter) (No Volumes) Actual Purge Vaiume = _ aailons <br /> Waiftifer CCasitsr:t Qia,meter fli:tohesl = Galionsiameax footl Z—C t7- 4=C.56 1,6�'=1 5. 8=2.T <br /> Groundwater Parameter Measurement: Meter Type/ si- 3 Caftrated 1/Yes_„_No <br /> TIME ELAPSED FLOINRAT OTW pH EC TuRsiorrY REDOX COMMENTS <br /> TIME iORM1 (R) anhoslcra (� mV <br /> dog F <br /> CI �SiS / f �G <br /> 3 � s IV <br /> `f `7 - l _ <br /> I I <br /> ITAW <br /> I <br /> I � _ <br /> ASSOCJAT S INC. <br /> SWRONAWNrAL GEOTECHNICAL AHO mATaVAL4 PROPESOCKALS <br />