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• <br />Address: <br />Well ID: <br />Collected By: <br />Total Depth (feet): <br />Screen Length (feet): <br />Casing Diameter (inches): <br />J <br />DOMESTIC/MUNICIPAL PROGRAM <br />WELL SAMPLING DATA SHEET <br />Date: <br />Purge Start Time: <br />Purge End Time: <br />� I%Yr7 <br />14 tip <br />14'.t o <br />Sampling Time: I q ! q, <br />Purge Sample Rate: `5 d P /Y"1 <br />4 Total Purge Volume (@ SO ! <br />Gallons Purged <br />pH <br />Conductivity <br />(us/cm) <br />Temperature <br />('C) <br />Other <br />0 <br />Comments: <br />Field Certification: 7-1 Z <br />Signed Date <br />