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• <br />• <br />0 <br />DOMESTIC/MUNICIPAL PROGRAM <br />WELL SAMPLING DATA SHEET <br />Address: b 350 S4 rt � Ddte: <br />Well ID: ..}� Purge Start Time: 1.!(f) <br />y <br />Collected By: 1 _ Purge End Time: 1%413 <br />Total Depth (feet): Sampling Time: �1 <br />Screen Length (feet): Purge Sample Rate: (� <br />Casing Diameter (inches): 6 �) Total Purge Volume (li <br />Gallons Purged <br />PH <br />Conductivity <br />(us/cm) <br />Temperature <br />ro <br />other <br />Comments: dr ea- o n1 `�X %CSV S e " r n <br />Wel 1pC c�.�Jpn � "i'ti 4 v,J S <br />dP 00- � 1 <br />b 1e (A.y <br />'-b ,bb 1ah6st� hov 5e <br />(iti <br />Field Certification: <br />Signed Date <br />