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E <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 />-7q LJ",e: -71xh <br />----Purge Startrime: <br />Purge End rime: <br />Sampling rime: <br />Purge Sample Rate: <br />I Purge Volume (E <br />Conductivity Temperature <br />Gallons Purged PH (us/cm) (10 Other <br />31-11 <br />F- —21 aL 109 (fP(Air <br />fkunents: <br />(�cr 0 fAA--- (2d, A,4 VNOQ <br />Field Certification: <br />Signed Date <br />C7 <br />