Laserfiche WebLink
1 Date: $– <br /> GROUNDWATtA PURGE AND SAMPLE FORM (cont.) <br /> PROJECT NAME:-!�EkX_.� 2J <br /> PROJECT NUMBER:_ Z -a'V61 1 <br /> PERSONNEL:.— `T� .. <br /> SAMPLE DATA: <br /> TIME SAMPLED:__ <br /> DEPTH SAMPLED(fI): <br /> SAMPLING EQUIPMENT: /2_–s�1!G2 <br /> COMMENTS: — <br /> SAI�PL[ ..NO,Of COH TAINER PRESE .' nELO VOLUME - � SAPPED UNDER ANALYSIS. <br /> RVATIVE Ell TUR6tUITY COLOR CRIMOPCUSTOOY -- REQUEST, -COMMiNT5 <br /> .No, CONTAINERS TYPE RL7ItAnON mI -U. ATI'C(YMJ _ .,IWET',Oo)' <br /> i7�A.�,. <br /> Fl-z <br /> r' .. <br /> PURGE WATER DISPOSAL NOTES: <br /> TOTAL DISCHARGE(gal): <br /> DISPOSAL METHOD:__ <br /> DRUM DESIGNATIONS)/VOLUME: <br /> COMMENTS:,_ <br /> WELL HEAD CONDITIONS C.1ECKLIST(Circle YES or NO--if NO,add comments) <br /> WELL SECURITY DEVICES OK(BOLLARDS,CHRISTY LID CASING LID AND LOCK)?: E NO <br /> INSIDE OF WELL HEAD AND OUTER CASING DRY?:YES NO <br /> WELL CASING OK?: -CE -� NO <br /> COMMENTS: <br /> GENERAL <br /> WEATHER CONDITIONS: <br /> TEMPERATURE(specify'C/'F): <br /> PROBLEMS ENCOUNTERED DURING PURGING OR SAMPLING? <br /> COMMENTS: <br /> c.c. Project Manager. <br /> Job File: <br /> Other: <br />