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0 <br />• <br />0 <br />Address: <br />Well ID: <br />Collected' By: <br />Total Depth (feet): <br />Screen Length (feet): <br />Casing Diameter (inches): <br />DOMESTIC/MUNICIPAL PROGRAM <br />WELL SAMPLING DATA SHEET <br />L Z'3'Z Av-c-- h 9xi Date: <br />Purge Start Time: <br />AT KA Purge End Time: <br />Sampling Time: <br />MWIVAIR <br />• i <br />Purge Sample Rate: `a nif t-r <br />i <br />Total Purge Volume (g %cam <br />Gallons Purged <br />pH <br />Conductivity <br />(us/cm) <br />Temperature <br />('C) <br />Other <br />rci <br />2�-4,r°3 <br />Comments: Gr' g -.s K-f_c-1 4f h Ct w� 5.c� v-►� P l <' �'r cs.Y'1 in c�s,.c' t <br />Field Certification; <br />Signed Date <br />