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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 />13 %-1 Ie R0Date: <br />`' Purge Start Time: <br />AT Purge End Time: <br />Sampling Time: <br />L 111-1 <br />iL.PL4P <br />Purge Sample Rate: ,S a sn-y7 <br />Total Purge Volume (E '1'S <br />Gallons Purged <br />pH <br />Conductivky <br />(us/cm) <br />Temperature <br />('C) <br />Other <br />'Z3 ?>4 <br />Comments: C)w��jerr ciskt--cJ i ham+ c,.je- Sr rv,Pie. Fll-oiti, hose in <br />�n f ya rel wh +--vN I s COn n C. eci =I I V -.E. c,+o well, <br />Field Certification: z i 7 <br />Signed Date <br />0 <br />