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DOMESTIC/MUNICIPAL <br />ELL SAMPLING DATA SHEET <br />Address: � ..,. �.- <br />Date: r 7 <br />Well ID: } Purge Start Time: 3 <br />Collected By: urge End Time: pt i ) <br />Total Depth (feet): Sampling Time: 1i 44 <br />Screen Length (feet):Purge Sample Rate: * 0 <br />ti a _ <br />Casing Diameter (inches): Total Purge Volume (� 70 --- <br />Conductivity Temperature <br />Gallons Purged pH (us/cm) ("C) Other <br />0 ®' 1., <br />Comments: vo <br />Field Certification: <br />Signed V Date <br />1-2 <br />�Q r <br />