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' Harding Lawson Assocraf GROUND-1 ITER SAMPLING FORM <br /> Engineering and <br /> Environmental Services Well No W— —7 <br />' Job Name V Well Type >�Monitor ❑ Extraction ❑Other <br /> ,, Well Material X PVC 1:1 St Steel ❑ Other <br /> �ob Number S . (. Date 6— Time <br />' Recorded by �,.,. 9 Sampled by <br /> fSgn (7nmdlsJ <br /> � 'Jrt+r.� <br /> PlJRd1lid <br /> Casing Diameter(D in inches) Q Bailer Type <br /> e2-inch Q 4-inch ❑6-inch Q Other AQ Submersible Q Centrifugal Q Bladder Pump No <br />' Total Depth of Casing (TD in feet BTOC) Q Other-Type <br /> Water Level Depth (WL in feet BTOC) <br /> Number of Well Volumes to be purged(#Vols) + �� <br /> X3 Q 4 05 Q 10 Q Other Near Bottom Q Near Top Q Other <br />' Depth in feet(BTOC) Screen Interval in Feet(BTOC) <br /> RG �Q from �o to <br /> 40_ - 7 a X �, 2X 3 X 0 0408 = gallons <br /> ` TD (teet) WL(feet) D(inches) #Vols Calculated Purge Volume <br /> 1 Ir ffifflimm <br /> 1f-1`b Start 11'4q Stop Elapsed Initial gpm Final gpm gallons <br />' Minutes Since P Cond TQC Other Minutes Since pH Cond T❑C Other <br /> Pumping Began p (µmhos/cm) ❑ F Pumping Began (µmhos/cm) 0 O <br /> Meter Nos <br /> ' Observations During Purging(Well Condition,Turbidity Color,Odor) r�4�� a e— <br /> Discharge Water Disposal Q Sanitary Sewer ❑ Storm Sewer If Other <br /> r <br /> tO Same As Above <br /> 'f Bader-Type 5 t+n 1e.5 5 S LS 4.1 Q Grab-Type <br /> ' Q Submersible Q Centrifugal Q Bladder, Pump No ❑ Other-Type <br /> Sample Series <br /> ' Sample No Volume/Cont Analysis Requested Preservatives Lab Comments <br /> � flw�l <br /> ' Duplicate Samples Blank Samples Other Samples <br /> Original Sample No Duplicate Sample No Type Sample No Type Sample No <br /> ' <br /> Q748 <br /> AL004 O.nCwW,e F� cow .+�.m c <br /> uan <br />