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• <br />0 <br />DOMESTIC/MUNICIPAL PROGRAM <br />WELL SAMPLING DATA SHEET <br />Address: ,� Date: <br />Well ID: ' Purge Start Time: <br />Collected By: Purge End Time: <br />Total Depth (feet): Sampling Time: <br />Screen Length (feet): Purge Sample Rate: /_18 <br />Casing Diameter (Inches): Total Purge Volume (E AIF) <br />Comments: o V d ° i <br />Field Certification: `� Ll <br />Signed Date <br />