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ACTON e MICKELSON • van DAM, INC. <br /> SAMPLING/DEVELOPMENT INFORMATION <br /> Project Name LAOi Lk <br /> Sampling/Development Point m_ <br /> Sample I D Project No Iq D <br /> Describe Sampling/Development Point Work Order # <br /> Date---z,j2 1 015 _ <br /> Field Crew RL(a <br /> Well Depth `�3 �r <br /> p feet below MP Casing Diameter y inches <br /> Depth to Water (below MP) (v S. $ I feet <br /> Discharge Rate -pm Time 08 015 A�PM <br /> Number of borehole volumes <br /> evacuated before sampling } 3 <br /> Sampling/Development Method <br /> Tap Bailer Centrifugal Pump <br /> Submersible Other <br /> Pump intake or bailer set at feet below MP <br /> Sample Appearance <br /> Note any Sampling Problems .tom <br /> :vote any Equipment Washing ���_ pt�?C _ <br /> Samples Collected/Time <br /> EVACUATION/STABILIZ,kTION TEST DATA <br /> Temperature Cumulative <br /> Corrected Water Level Volume of Water Pumping <br /> pH Conductance Temperature (nearest Removed from Well Rate <br /> Time (units) (umhos/cm) (°C) 0 01 foot) (gallons) (gpm) <br /> oa: 1g 1 ID -7 6z U(' ?> Co <br /> 08 , 31 -7 '�18 `7 7 (0 (05 v Z <br /> off ` 145 -7. y5 '7 . `7Z <br /> 9 <br /> Bailing Start Time O a Q'!5- _ WL <br /> Bailing Stop Time 3 t.{ 5 WL GIs `7 Q <br /> Comments <br /> Signature Date 3'Z. lc} 5 <br />