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GRCUNOWATER SAMPLING FORM <br /> PSC IE:i fNFCRMA s IICN { <br /> #RCJEZ–i NAME L.,1, lo— PFCJEZr NUMEE= =4{ IZW71, W- 1 VNE_L NO All-J ; <br /> J <br /> F=CJEz i MANPGc:R 7/F=— CF NE! ImcnitonngExtrcaan Cthe, <br /> I I <br /> RE--4RCED, 10( <br /> CAMF!=- BY K DA i E <br /> VNE Cr tFGNG INF:DRUA r ICN i <br /> j=UIRGE VCLUiME ✓uFCGC 1�E1 rGD <br /> Casing Diameter r <br /> Z-nc- s_ncn Cther X Railer - Tvpe <br /> P'.mp ' Type <br /> I Weii rcmi Caoth G fee:welew i cm of Casing,TD Other - Sgec tv <br /> E <br /> Ceeth to Water feet tetow Too of Casing,WL Hyarncarean Cocrs I <br /> Ves No } <br /> I 'Nater Calumn Lernash feat <br /> E <br /> Purge Vctume Caic.:lancn (Water Casumn_ Length x ,muit mier x Ne Volumes = C;Q c.:laiec surge Volume) <br /> c4 / <br /> Caic-dated Purge Volume ailans <br /> (WC,.) (Mulhl3Uer) (No Vaiumes) Acmai Purge Vaturne = 4ailcns <br /> I <br /> it��nller fCsrM otarre*er f wes€ =Gakr--3jlmesrSocd — &= 5 8=Z5 e <br /> t <br /> Smunawater aarameter Measurement Mete,-vpe Calibrated Yes_wo <br /> E <br /> i <br /> 7NE °_I?SEC =l vv RA =— [)—I%N pts � TU�tCrf f RE:CX CCMMEVTS <br /> 7ME (r=a*+n (ft) I mn= n saga (N mV �s�� b y l•�f <br /> ' 1 I c),vu 1 I I a I i 1w I s6 I /t/4 Itfl, I cte v I <br /> �24- I616 A I j ,lyz. 17-0 S 1 <br /> 'T= <br /> I I ► I I I I I I I <br /> I I I I I I I I I <br /> I I I i I I <br /> i I I I I I I I I <br /> I I I I I i <br /> 1 I I I I I I <br /> I I I I I I I I <br /> i <br /> oxer a r.Eorr-cuxASSO�AT INC. <br /> E VWR Eh'F lti L AMC <br />