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GROUNDWATER SAMFIE COLLECTION DATA FORM <br /> SAMPLE I D NO : WELL NUMBER: __V_ <br /> DATE/TIME• 1.l-�-2 7 )z I g WEATHER: C/par wcb­� <br /> ANALYSIS mist--,gv%d _ _OrIgKor _b <br /> WELL PURGING DATA. FILTERED? Yea Q <br /> Initial depth to water: Filter Device: In-Line <br />' Depth of well. Filter barrel <br /> Volume of water in well: 1 ,57 - Lab <br />' Datettime at atart of purging: 12- ' ? Other <br /> Method of purging: ►3a r �r <br /> Method of Decontaminating <br />' purging equipment: <br /> iP <br /> WATER QUALITY OBSERVATIONS DURING PURGING: <br />' Volume Depth to <br /> Date./tune purged water Temp. OF pH EC Umhos <br /> Z )2;18 Z <br /> O ! Ig koq re <br /> r <br /> 1 <br /> SAMPLE CONTAINER DATA. SAMPLE METHOD. <br /> Puln <br /> Number/type of container: zz <br /> Other. <br />' VOA capacity: <br /> preserve: <br /> Amber capacity: Z16 ox <br /> preserve- - Co- <br /> Plastic <br /> - <br /> Plastic capacity: <br />' preserve: <br /> Other (describe): <br /> SAMPLE PRESERVA ON METHOD: <br /> Iced Other (describe): <br /> Signature: Date/Time: y-Z <br /> Foe D, Mwch1M <br />