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C7 <br />Address: 'fit../ ?— Rc'a Date: �15 11 <br />Well ID: `® Purge Start Time: • b <br />Collected By: r1T '� Purge End Time: 1 '• i <br />Total Depth (feet): Sampling Time: (l <br />Screen Length (feet): Purge Sample Rate: <br />Casing Diameter (inches): Total Purge Volume (f <br />Conductivity Temperature <br />Gallons Purged pH (us/cm) ('C) Other <br />Comments: <br />Field Certification; <br />Signe Date <br />