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i <br /> ACTON • MICKELSON • van DAM, INC. <br /> SAMPLING/DEVELOPMENT INFORMATION <br /> Project Name LAN <br /> Sampling/Development Point MW Z <br /> Sample I D Project No 1 c1oZO <br /> 16 <br /> Describe Samplmg/Development Point Work Order # <br /> Date °1 I 1 S I aH _ <br /> Field Crew`-(o <br /> rt <br /> Well Depth s feet below MP Casing Diameter y inches <br /> Depth to Water (below MP) _ 71 161 feet <br /> Discharge Rate gpm Time 07 ZO �/PM <br /> Number of borehole volumes <br /> evacuated before sampling y <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 <br /> Note any Equipment Washing <br /> Samples Collected/T=e <br /> i <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) (umhog/cm) (°C) 0 01 foot) (gallons) (g-pin) <br /> 1Z•10 Z•15 1Z Z� 13 �3 7 <br /> 1Z18 -7 Z"? 1 ! . 9 5 7Z. 15 <br /> � Z= 25 z9 I1 . 50 `73. (V ZZ <br /> l2 ' 35 33 I . Z9 '73. 4 Zq <br /> Bailing Start Time 1 Z t WI- <br /> Bailing <br /> LBailing Stop Time 1 WL <br /> Comments <br /> Signature Date <br />