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ACTON • MICKELSON * van DAM, INC. <br /> SAMPLING/DEVELOPMENT INFORMATION <br /> Protect Name t401LA <br /> Sampling/Development Paint 4 <br /> Sample I D Project No q0n <br /> Describe Sampling/Development Point Work Order # <br /> Date_ NIC 'A <br /> Field Crew R... <br /> n <br /> Well Depth B 3 feet below N11P J Casing Diameter H inches <br /> Depth to Water (below MP), Z _ feet <br /> Discharge Rate gpm Time PM <br /> Number of borehole volumes <br /> evacuated before sampling 3 <br /> Sampling/Development Method <br /> Tap Bailer Centnfugal Pump <br /> Submersible Other <br /> Pump <br /> intake or bailer set at feet below MP <br /> Sample Appearance _ CIL-C-PA _ <br /> Note any Sampling Problems <br /> Note any Equipment Washing <br /> Samples Collected/Time 00 A—'- <br /> EVACUATION/STABILIZATION 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 /> to l 5 8 . 5 5 5 `3 l0 <br /> too. 2 10 <br /> lo'• 35 $ �� S <br /> 9U 6Z. Z Z O <br /> to 9y bz 8 30 <br /> Bailing Start Time c WL- <br /> Bailing <br /> L Bailing Stop Time 1 Q • 5 5 WL (o q• 8 9 I <br /> Comments <br /> Signature Date 1l�1b qLl <br />