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• DOMESTIC/MUNICIPAL PROGRAM <br /> WELL+ SAMPLING DATA SHEET <br /> Address: a-2a �ar' �� Date: 1.4. ( 7 <br /> Well ID: Purge Start Time: 1061 <br /> Collected By: 7u- Purge End Time: g o t <br /> Total Depth(feet): Sampling Time: <br /> Screen Length(feet): Purge Sample Rate: b <br /> Casing Diameter(inches): / Total Purge Volume(@ <br /> Conductivity Temperature <br /> Gallons Purged pH (us/cm) ('C) Other <br /> ra o CA Z <br /> s <br /> Comments: <br /> Well <br /> . n <br /> ( ell 'bC,�i 404�, <br /> t.+wnr w,V- 44p, O -A," h#JS f UMC 11V S-e <br /> &Lmee 1aCo.*'o--\ Not h4e,J-t <br /> Field Certification: 7, <br /> bl,)l// <br /> Signed Date <br /> • <br />