Laserfiche WebLink
Groundwater Purge and SamplArm Date: Hedy/Jenks Consultants <br /> PROJECT NAME: WELL NUMBER: <br /> PROJECT NUMBER: /T 9,9 ? syo. oo PERSONNEL:- <�� h�7 <br /> SAMPLE DATA: <br /> TIME SAMPLED: /,' Y COMMENTS: <br /> DEPTH SAMPLED (FT): <br /> SAMPLING EQUIPMENT: <br /> NO. OF CON- FIELD VOLUME SHIPPED UNDER ANALYSIS <br /> SAMPLE CONTAIN- TAINER PRESER- FILTRA- FILLED CHAIN-OF-CUS- REQUEST <br /> NO. ERS TYPE VATIVE TION (ml or L) TURBIDITY COLOR TODY AT 4°C? (METHOD) COMMENTS <br /> PURGE WATER DISPOSAL NOTES: /' _ <br /> TOTAL DISCHARGE (GAL): u�i S COMMENTS: <br /> DISPOSAL METHOD:Sy <br /> DRUM DESIGNATIONS)/VOLUME PER (GAL): <br /> WELL HEAD CONDITIONS CHECKLIST (CIRCLE YES OR NO - IF NO ADD COMMENTS): <br /> WELL SECURITY DEVICES OK (BOLLARDS, CHRISTY LID, CASING LID AND LOCK)?: YES NO <br /> INSIDE OF WELL HEAD AND OUTER CASING DRY?: YES NO <br /> WELL CASING OK?: ES NO pp <br /> COMMENTS: <br /> GENERAL: <br /> WEATHER CONDITIONS: <br /> TEMPERATURE (SPECIFY °C OR °F): <br /> PROBLEMS ENCOUNTERED DURING PURGING OR SAMPLING? <br /> cc: Project Manager: <br /> Job File: <br /> Other: <br /> F-43.2(5-89) Page 2 of 2 <br />