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---------------- <br /> ACTON - MICKELSON - van DAM, INC <br /> SAMPLING/DEVELOPMENT INFORMATION <br /> Sampling/D velopment Point l9'�W Project <br /> Location�&5,�CV V A191K Work Order # <br /> Sample LD. Date Sampled/Developed tQ -2c-d>3 <br /> Describe Sampling/Development Point Time A WM <br /> Well I>epth 83 feet below MP Casing Diameter inches <br /> Depth to Water (below MP) 73• 'If feet Date_Z6 •26 -53 Time d AM/PM <br /> Discharge Rate 2 gpm " <br /> At least 3 bore volumes have been evacuated before sampling. <br /> Sampling/Development Method: <br /> —�. Tap Bailer Centrifugal Pump <br /> X Submersible Other <br /> Pump intake or bailer set at feet below MP. <br /> Sample Appearance: Odor: _%071-L <br /> Note any Sampling Problems: <br /> Note any Qeaning or Effort to Reduce Possible Cross-Contamination: c&xo. �. <br /> ampler Collected: Zo ;&,e a <br /> EVACUATION/STABU- ZATION TEST DATA <br /> Temperature .Cumulative <br /> Corrected Volume of Water Pumping <br /> pH Conductance Temperature Water Level Removed from Well Rate <br /> Time (units) (umhos/cm) (°C) (nearest 0.0I foot) (gallons) (gpm) <br /> 76 a •8� _70?.ell 73. 9 Z <br /> 73 2 . 10 <br /> Bailing Start Time //38 <br /> Bailin Stop Time WL23-VI <br /> 3-VI <br /> S P WL <br /> ruments: <br /> Form Completed By: ��,; �� Witnessed By: <br />