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Date _c <br /> 1 '� �`�, Set up time 1 2 Y 3- <br /> d' Weather n.v �^ <br /> Y �� <br /> • � � £ F ;I~: 33U kis^ , :® Samplers f6 <br /> _� <br /> WELL # MW-5 <br /> HISTORIC CONCENTRATIONS <br /> Location Construction Depth 10'bgs <br /> Construction 2 inch pvc/ Depth to Packer <br /> Groundwater Zone Pump Intake <br /> Screened Interval 5-10' bgs Measured Depth <br /> Purge Setting Discharge / Refill Depth to Water -7, S <br /> Sample Setting Discharge Height of Water Column .',l 1¢ <br /> Volume of one casmg 0 U <br /> Packer Pressure <br /> Purge Start Tune 12S-0 Purge calculations <br /> Discharge Rate ,411 <br /> ft x 163 gals / ft x 3= <br /> Purge End Time 5- 1 oZ gallons <br /> Time Gallons Temp. pH EC Water clarity <br /> IS,53 1 S`0 2© . /Z Z- a <br /> ANALYSES REQUIRED SAMPLE TIME CONTAINER'TYPE FILTRATION? <br /> 616-PA M- g 015/W f 3 O.3 (3) Q W+a ✓r1,i <br /> Wr ,� <br /> xPR�'M" <br /> FIELD OBSERVATIONS(Well condition,repairs needed) <br /> PID reading when well cap opened Disposal method of purge water <br /> Dissolved Oxygen reading Decontamination procedure None/Alconox-DI Rinse <br /> Turbidity Measurement <br /> Other notes <br /> � pq:- /Y\ 14 01> <br /> Sampler Signature(s) <br />