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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 />DOMESTIC/MUNICIPAL PROGRAM <br />WELL SAMPLING DATA SHEET <br />Purge Start Time: ' � 3u <br />qPurge End Time: I <br />r� �5 <br />Sampling Time: q1// <br />T� Purge Sample Rate: b � <br />u Total Purge Volume (F <br />Gallons Purged <br />pH <br />Conductivity <br />(us/cm) <br />Temperature <br />('C) <br />Other <br />I 0S <br />S&q <br />051 t <br />Comments: h btat� <br />Weu ( aL(A�-1 _C-kvV­, wI�S* +1,�O_ KOs; -Se y <br />W.1 i h u 5 c, 5uvyl e oc-A- <br />Field Certification: ij— g ---J"" <br />Signe Date <br />0 <br />